• Ugo Corrà, Alessandro Mezzani, Andrea Giordano, Roberto Caruso, and Pantaleo Giannuzzi.
• Division of Cardiology, Laboratory for the Analysis of Cardio-respiratory Signals, Salvatore Maugeri Foundation, IRCCS, Via per Revislate 13, Veruno, NO, Italy. ucorra@fsm.it
• Eur J Prev Cardiol. 2012 Apr 1;19(2):185-91.

AbstractIn 2004, a cardiopulmonary exercise testing (CPET) prognosticating algorithm for heart failure (HF) patients was proposed. The algorithm employed a stepwise assessment of peak oxygen consumption (VO2), slope of regression relating minute ventilation to carbon dioxide output (VE/VCO2) and peak respiratory exchange ratio (RER), and was proposed as an alternative to the traditional strategy of using a single CPET parameter to describe prognosis. Since its initial proposal, the prognosticating algorithm has not been reassessed, although a re-evaluation is in order given the fact that new HF therapies, such as beta-blocker therapy, have significantly improved survival in HF. The present review, based on a critical examination of CPET outcome studies in HF patients regularly treated with beta-blockers, suggests a new prognosticating algorithm. The algorithm comprises four CPET parameters: peak RER, exertional oscillatory ventilation (EOV), peak VO2 and peak systolic blood pressure (SBP). Compared to previous proposals, the present preliminary attempt includes EOV instead of VE/VCO2 slope as ventilatory CPET parameter, and peak SBP as hemodynamic-derived index.

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