Cardiopulmonary Exercise Testing (CPET) Responses and ProBNP Levels With Progressive Degrees of Diastolic Dysfunction

Abstract

SESSION TITLE: Cardiovascular PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PMPURPOSE: The objective of this study is to evaluate cardiopulmonary exercise testing (CPET) in varying degrees of diastolic dysfunction (DD) for significant abnormalities in selected variables, particularly maximal oxygen consumption (VO2 max) and ventilatory equivalent of carbon dioxide (VE/VCO2). The secondary objective is to detect any clinical correlation between proBNP level and CPET abnormalitiesMETHODS: Transthoracic echocardiograms were reviewed to identify patients with diastolic dysfunction. Selected participants performed a maximal exercise CPET with breath by breath gas analysis. After completion of the CPET, studies were reviewed for evidence of cardiac or ventilatory limitation to exercise based on predicted reference values. Particular review was initially performed for VO2 max and VE/CO2 values in these patients. A proBNP level was drawn no more than 24 hours prior to the CPET.RESULTS: Fifteen eligible participants with grade 1 or II DD have completed the CPET to date. Preliminary results show an average VO2 max for grade I and grade 2 DD of 2.33 and 2.14 L/min respectively. Preliminary data also shows a VE/CO2 at AT average for grade 1 DD of 27.63 and 28.29 for grade II DD. Initial VE/VCO2 slope for grade I DD of 27.8 and 28.5 for grade II DD have also been observed. A preliminary average proBNP of 52 and 125 have been recorded for grade I and grade II DD patients respectively.CONCLUSIONS: Preliminary data from this study indicate a decreased VO2 max, increased VE/VCO2 at AT and slope, and increased proBNP for grade II DD. These variables have been clearly demonstrated to be abnormal in patients with diastolic heart failure. The trend in CPET values with worsening degrees of diastolic heart failure may help lead to development of new expected ranges for DD patients during exercise.CLINICAL IMPLICATIONS: This study will help to answer several questions including at what degree of DD does CPET reflect abnormal VO2 max and/or VE/VCO2 and is there any correlation between proBNP levels and the above noted CPET abnormalities.DISCLOSURE: The following authors have nothing to disclose: Jesse Sherratt, Kenneth LeclercNo Product/Research Disclosure Information