Comparison of V̇O2-Kinetic Parameters for the Management of Heart Failure

Objective:; The aim of this study was to analyze whether V̇O; 2; -kinetics during cardiopulmonary exercise testing (CPET) is a useful marker for the diagnosis of heart failure (HF) and to determine which V̇O; 2; -kinetic parameter distinguishes healthy participants and patients with HF.; Methods:; A total of 526 healthy participants and 79 patients with HF between 20 and 90 years of age performed a CPET. The CPET was preceded by a 3-min low-intensity warm-up and followed by a 3-min recovery bout. V̇O; 2; -kinetics was calculated from the rest to exercise transition of the warm-up bout (on-kinetics), from the exercise to recovery transition following ramp test termination (off-kinetics) and from the initial delay of V̇O; 2; during the warm-up to ramp test transition (ramp-kinetics).; Results:; V̇O; 2; off-kinetics showed the highest; z; -score differences between healthy participants and patients with HF. Furthermore, off-kinetics was strongly associated with V̇O; 2peak; . In contrast, ramp-kinetics and on-kinetics showed only minimal; z; -score differences between healthy participants and patients with HF. The best on- and off-kinetic parameters significantly improved a model to predict the disease severity. However, there was no relevant additional value of V̇O; 2; -kinetics when V̇O; 2peak; was part of the model.; Conclusion:; V̇O; 2; off-kinetics appears to be superior for distinguishing patients with HF and healthy participants compared with V̇O; 2; on-kinetics and ramp-kinetics. If V̇O; 2peak; cannot be determined, V̇O; 2; off-kinetics provides an acceptable substitute. However, the additional value beyond that of V̇O; 2peak; cannot be provided by V̇O; 2; -kinetics.