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European Heart Journal Advance Access published online on June 26, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp176
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Peak exercise responses in heart failure: back to basics

Alain Cohen-Solal1,*, Florence Beauvais1 and Lip-Bun Tan2

1 Département de cardiologie, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris; Université Paris-Diderot; INSERM U942; 2, rue Ambroise-Paré, 75475 Paris Cedex 10, France
2 Cardiology Department, Leeds General Infirmary, Leeds LS1 3EX, UK

* Corresponding author. Tel: +33 1 4995 6608, Fax: +33 1 4995 8439, Hopital Lariboisiere, Assistance Publique, 2 rue Ambroise Pare, 75010 Paris, France. Email: alain.cohen-solal@lrb.aphp.fr.

This editorial refers to ‘Exercise haemodynamic variables rather than ventilatory efficiency indexes contribute to risk assessment in chronic heart failure patients treated with carvedilol’, by U. Corrà et al. doi:10.1093/eurheartj/ehp138

The first 10% of the full text of this article appears below.

Evaluating central haemodynamics became a prominent cardiological feature in the 1950s following Sarnoff and Berglund's introduction of Starling's Law into practice via a family of ventricular function curves,1 but it went out of favour after 1981 when Benge2 and Franciosa3 claimed discrepancy between haemodynamics and exercise capacity in heart failure (HF) patients. Dismissing its value became fashionable in subsequent decades with further emphasis of its dissociation with changes in symptoms. In 1991, Mancini and colleagues4 greatly contributed to the widespread use of cardiopulmonary exercise testing (CPX) by showing its prognostic value in patients with severe HF referred for transplantation. Since this landmark study, a large number of studies have confirmed the unsurpassed prognostic value of peak exercise capacity, generally reported as peak oxygen consumption (peak VO2/kg), in HF patients. The simple explanation for this is that, according to the Fick principle, peak exercise VO2 is determined by peak . . . [Full Text of this Article]


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