Imperial College London
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ProfessorJamilMayet

Faculty of Medicine, National Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7594 1006j.mayet

 
 
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Assistant

 

Miss Juliet Holmes +44 (0)20 7594 5735

 
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Location

 

NHLI offices,Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Barron:2016:10.1016/j.jchf.2015.11.003,
author = {Barron, A and Francis, DP and Mayet, J and Ewert, R and Obst, A and Mason, M and Elkin, S and Hughes, AD and Wensel, R},
doi = {10.1016/j.jchf.2015.11.003},
journal = {JACC: Heart Failure},
pages = {252--261},
title = {Oxygen uptake efficiency slope and breathing reserve, not anaerobic threshold, discriminate between patients with cardiovascular disease over COPD},
url = {http://dx.doi.org/10.1016/j.jchf.2015.11.003},
volume = {4},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives To compare the relative discrimination of various cardiopulmonary exercise testing (CPX) variables between cardiac and respiratory disease.Background CPX testing is used in many cardiorespiratory diseases. However discrimination of cardiac and respiratory dysfunction can be problematic. Anaerobic threshold (AT) and oxygen-uptake to work-rate relationship (VO2/WR slope) have been proposed as diagnostic of cardiac dysfunction, but multiple variables have not been compared.Methods 73 patients with chronic obstructive airways disease (COPD, n=25), heart failure with reduced ejection fraction (HFrEF, n=40) or combined COPD and HFrEF (n=8), were recruited and underwent CPX testing on a bicycle ergometer. Following a familiarisation test, each patient underwent a personalised second test aiming for maximal exercise after ~10 minutes. Measurements from this test were used to calculate area under receiver-operator characteristic curve (AUC). Results PeakVO2 was similar between the 2 principal groups (COPD 17.1±4.6ml/min/kg (mean±SD), HFrEF 16.4±3.6ml/min/kg). Breathing reserve (AUC 0.91) and percent predicted oxygen uptake efficiency slope (OUES) (AUC 0.87) had the greatest ability to discriminate between COPD and HFrEF. VO2/WR slope performed significantly worse (AUC 0.68). VO2 at the AT did not discriminate (AUC 0.56 for AT as percent predicted peakVO2). OUES and BR remained strong discriminators when compared with an external cohort of healthy matched controls, and were comparable to B-type natriuretic peptide.Conclusions Breathing reserve and OUES discriminate heart failure from COPD. Despite it being considered an important determinant of cardiac dysfunction, the AT could not discriminate these typical clinical populations whilst the VO2/WR slope showed poor to moderate discriminant ability.
AU  - Barron,A
AU  - Francis,DP
AU  - Mayet,J
AU  - Ewert,R
AU  - Obst,A
AU  - Mason,M
AU  - Elkin,S
AU  - Hughes,AD
AU  - Wensel,R
DO  - 10.1016/j.jchf.2015.11.003
EP  - 261
PY  - 2016///
SN  - 2213-1779
SP  - 252
TI  - Oxygen uptake efficiency slope and breathing reserve, not anaerobic threshold, discriminate between patients with cardiovascular disease over COPD
T2  - JACC: Heart Failure
UR  - http://dx.doi.org/10.1016/j.jchf.2015.11.003
UR  - http://hdl.handle.net/10044/1/28142
VL  - 4
ER  -
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