Respiratory exchange ratio overshoot during exercise recovery: a promising prognostic marker in HFrEF

ConclusionRER overshoot represents a meaningful cardiorespiratory index to monitor during exercise gas exchange evaluation; it is an easily detectable parameter that could support clinicians to comprehensively interpreting patients ’ functional impairment and prognosis. CPET recovery analyses should be implemented in the clinical decision-making of advanced HF.Graphical AbstractRER Overshoot during CPET recovery phase in HFrEFTransient increases, also called overshoot, in respiratory exchange ratio (RER) have been observed during exercise recovery in healthy subjects and patients with chronic diseases. A total of 190 patients with HFrEF who underwent CPET for heart transplant checklist were analyzed and compared with 103 controls, using a protocol to monitor gas exchange during recovery phase. RER overshoot was significantly lower in patients with HFrEF than controls, and some patients with HFrEF (17.4%) presented no overshoot. The presence of RER overshoot was associated with higher aerobic capacity and cardiorespiratory efficiency with lower risk of cardiovascular events and longer transplant/LVAD-free survival. HFrEF, heart failure with reduced ejection fraction; CPET, cardiopulmonary exercise testing; LVAD, left ventricular ejection fraction.
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research