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Reproducibility of onset and recovery oxygen uptake kinetics in moderately impaired patients with chronic heart failure.

ABSTRACT: Oxygen (O2) kinetics reflect the ability to adapt to or recover from exercise that is indicative of daily life. In patients with chronic heart failure (CHF), parameters of O2 kinetics have shown to be useful for clinical purposes like grading of functional impairment and assessment of prognosis. This study compared the goodness of fit and reproducibility of previously described methods to assess O2 kinetics in these patients. Nineteen CHF patients, New York Heart Association class II-III, performed two constant-load tests on a cycle ergometer at 50% of the maximum workload. Time constants of O2 onset- and recovery kinetics (tau) were calculated by mono-exponential modeling with four different sampling intervals (5 and 10 s, 5 and 8 breaths). The goodness of fit was expressed as the coefficient of determination (R2). Onset kinetics were also evaluated by the mean response time (MRT). Considering O2 onset kinetics, tau showed a significant inverse correlation with peak- VO2 (R = -0.88, using 10 s sampling intervals). The limits of agreement of both tau and MRT, however, were not clinically acceptable. O2 recovery kinetics yielded better reproducibility and goodness of fit. Using the most optimal sampling interval (5 breaths), a change of at least 13 s in tau is needed to exceed normal test-to-test variations. In conclusion, O2 recovery kinetics are more reproducible for clinical purposes than O2 onset kinetics in moderately impaired patients with CHF. It should be recognized that this observation cannot be assumed to be generalizable to more severely impaired CHF patients.

SUBMITTER: Kemps HM

PROVIDER: S-EPMC1914232 | biostudies-other | 2007 May

REPOSITORIES: biostudies-other

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Project description:Monitoring aerobic exercise intensities of free-living physical activities is valuable for purposes such as education and research. The heart rate (HR) method, based on the linear relation between HR and oxygen uptake (VO2), is potentially valuable for this purpose. Three prerequisites are that the method is reproducible, and valid for the specific form of physical activity executed as well as under field conditions. The aim of this study is to evaluate reproducibility of the heart rate method in the laboratory. VO2 and HR measurements were made on two different occasions during three submaximal (model 1) plus a maximal exercise intensity (model 2) on a cycle ergometer in the laboratory. 19 habitual commuter cyclists (9 males and 10 females), aged 44 ± 3 years, were measured. The reproducibility of the estimated VO2, based on three levels of HR from commuting cycling and the regression equations from test and retest were analyzed. Differences between the two models were also studied. For both models, there were no significant differences between test and retest in the constituents of the regression equations (y-intercept, slope and r-value). Neither were there any systematic differences in estimated absolute levels of VO2 between test and retest. The relative differences between test and retest, based on estimations from three different levels of HR, were 0.99 ± 11.0 (n.s.), 2.67 ± 6.48 (n.s.) and 3.57 ± 6.24% (p<0.05) for model 1, and 1.09 ± 10.6, 1.75 ± 6.43 and 2.12 ± 5.92% (all n.s.) for model 2. However, some large individual differences were seen in both models. There were no significant differences between the two models in the slopes, intercepts or r-values of the regression equations or in the estimated levels of VO2. The heart rate method shows good reproducibility on the group level in estimating oxygen consumption from HR-VO2 relations in the laboratory, and based on three levels of HR which are representative for cycle commuting. However, on the individual level, some large variations were seen.

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Reproducibility of onset and recovery oxygen uptake kinetics in moderately impaired patients with chronic heart failure.

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