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Title: Cardiopulmonary exercise testing in systolic heart failure in 2014: The evolving prognostic role A position paper from the committee on exercise physiology and training of the heart failure association of the ESC
Authors: Corrà, Ugo 
Piepoli, Massimo F. 
Adamopoulos, Stamatis N. 
Agostoni, Piergiuseppe 
Coats, Andrew 
Conraads, Viviane Marie A 
Lambrinou, Ekaterini 
Pieske, Burkert Mathias 
Piotrowicz, Ewa 
Schmid, Jean Paul 
Seferovic, Petar M. 
Anker, Stefan D. 
Filippatos, Gerasimos S. 
Ponikowski, Piotr P. 
Major Field of Science: Medical and Health Sciences
Field Category: Basic Medicine
Keywords: Dystolic heart failure;Exercise testing;Prognosis
Issue Date: Sep-2014
Source: European Journal of Heart Failure, 2014, vol. 16, no. 9, pp. 929-941
Volume: 16
Issue: 9
Start page: 929
End page: 941
Journal: European Journal of Heart Failure 
Abstract: The relationship between exercise capacity, as assessed by peak oxygen consumption, and outcome is well established in heart failure (HF), but the predictive value of cardiopulmonary exercise testing (CPET) has been recently questioned, for two main reasons. First, the decisional power of CPET in the selection of heart transplantation candidates has diminished, since newer therapeutic options and the shortage of donor hearts have restricted this curative option to extremely advanced HF patients, frequently not able to perform a symptom-limited CPET. Secondly, the use of CPET has become more complex and sophisticated, with many promising new prognostic indexes proposed each year. Thus, a modern interpretation of CPET calls for selective expertise that is not routinely available in all HF centres. This position paper examines the history of CPET in risk stratification in HF. Throughout five phases of achievements, the journey from a single CPET parameter (i.e. peak oxygen consumption) to a multiparametric approach embracing the full clinical picture in HF-including functional, neurohumoral, and laboratory findings-is illustrated and discussed. An innovative multifactorial model is proposed, with CPET at its core, that helps optimize our understanding and management of HF patients.
ISSN: 1388-9842
DOI: 10.1002/ejhf.156
Rights: © European Society of Cardiology
Type: Article
Affiliation : Cyprus University of Technology 
IRCCS Fondazione ‘S. Maugeri’ 
G da Saliceto Hospital 
Onassis Cardiac Surgery Center 
Monash University 
Antwerp University Hospital 
Medical University Graz 
Institute of Cardiology 
Bern University Hospital 
Belgrade University School of Medicine 
Campus Virchow Klinikum 
Attikon University Hospital 
Wroclaw Medical University 
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