A novel cardiac output response to stress test developed to improve diagnosis and monitoring of heart failure in primary care

作者:Charman Sarah J; Okwose Nduka C; Stefanetti Renae J; Bailey Kristian; Skinner Jane; Ristic Arsen; Seferovic Petar M; Scott Mike; Turley Stephen; Fuat Ahmet; Mant Jonathan; Hobbs Richard F D; MacGowan Guy A; Jakovljevic Djordje G*
来源:ESC Heart Failure, 2018, 5(4): 703-712.
DOI:10.1002/ehf2.12302

摘要

AimsPrimary care physicians lack access to an objective cardiac function test. This study for the first time describes a novel cardiac output response to stress (CORS) test developed to improve diagnosis and monitoring of heart failure in primary care and investigates its reproducibility.
Methods and resultsProspective observational study recruited 32 consecutive primary care patients (age, 639years; female, n=18). Cardiac output was measured continuously using the bioreactance method in supine and standing positions and during two 3min stages of a step-exercise protocol (10 and 15 steps per minute) using a 15cm height bench. The CORS test was performed on two occasions, i.e. Test 1 and Test 2. There was no significant difference between repeated measures of cardiac output and stroke volume at supine standing and Stage 1 and Stage 2 step exercises (all P > 0.3). There was a significant positive relationship between Test 1 and Test 2 cardiac outputs (r=0.92, P=0.01 with coefficient of variation of 7.1%). The mean difference in cardiac output (with upper and lower limits of agreement) between Test 1 and Test 2 was 0.1 (-1.9 to 2.1)L/min, combining supine, standing, and step-exercise data.
ConclusionsThe CORS, as a novel test for objective evaluation of cardiac function, demonstrates acceptable reproducibility and can potentially be implemented in primary care.