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Observational Study
Feasibility of the cardiac output response to stress test in suspected heart failure patients.
- Sarah J Charman, Nduka C Okwose, Clare J Taylor, Kristian Bailey, Ahmet Fuat, Arsen Ristic, Jonathan Mant, Christi Deaton, Petar M Seferovic, CoatsAndrew J SAJS0000-0002-2771-4260Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy., HobbsF D RichardFDRNuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom., Guy A MacGowan, and Djordje G Jakovljevic.
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
- Fam Pract. 2022 Sep 24; 39 (5): 805-812.
BackgroundDiagnostic tools available to support general practitioners diagnose heart failure (HF) are limited.Objectives(i) Determine the feasibility of the novel cardiac output response to stress (CORS) test in suspected HF patients, and (ii) Identify differences in the CORS results between (a) confirmed HF patients from non-HF patients, and (b) HF reduced (HFrEF) vs HF preserved (HFpEF) ejection fraction.MethodsSingle centre, prospective, observational, feasibility study. Consecutive patients with suspected HF (N = 105; mean age: 72 ± 10 years) were recruited from specialized HF diagnostic clinics in secondary care. The consultant cardiologist confirmed or refuted a HF diagnosis. The patient completed the CORS but the researcher administering the test was blinded from the diagnosis. The CORS assessed cardiac function (stroke volume index, SVI) noninvasively using the bioreactance technology at rest-supine, challenge-standing, and stress-step exercise phases.ResultsA total of 38 patients were newly diagnosed with HF (HFrEF, n = 21) with 79% being able to complete all phases of the CORS (91% of non-HF patients). A 17% lower SVI was found in HF compared with non-HF patients at rest-supine (43 ± 15 vs 51 ± 16 mL/beat/m2, P = 0.02) and stress-step exercise phase (49 ± 16 vs 58 ± 17 mL/beat/m2, P = 0.02). HFrEF patients demonstrated a lower SVI at rest (39 ± 15 vs 48 ± 13 mL/beat/m2, P = 0.02) and challenge-standing phase (34 ± 9 vs 42 ± 12 mL/beat/m2, P = 0.03) than HFpEF patients.ConclusionThe CORS is feasible and patients with HF responded differently to non-HF, and HFrEF from HFpEF. These findings provide further evidence for the potential use of the CORS to improve HF diagnostic and referral accuracy in primary care.© The Author(s) 2022. Published by Oxford University Press.
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