Author + information
- Received February 4, 1985
- Revision received April 19, 1985
- Accepted May 15, 1985
- Published online October 1, 1985.
- Karl T. Weber, MD, FACCa and
- Joseph S. Janicki, PHD
- ↵aAddress for reprints: Karl T. Weber, MD, Cardiovascular Institute, Michael Reese Hospital and Medical Center, Lake Shore Drive at 31st Street, Chicago, Illinois 60616.
In patients with chronic heart failure whose cardiac output response to exercise is impaired, determination of anaerobic threshold may provide a useful and objective approach to grade the severity of heart failure. In such patients performing upright treadmill exercise to exhaustion, this study examined the reproducibility of the response of cardiac output and mixed venous lactate concentration when the exercise test was repeated the same or next day, the nature of this response after rest and exercise cardiac output levels were augmented by the cardiotonic agent amrinone and the response of lactate during symptom-limited submaximal exercise performed at either aerobic or anaerobic levels of work for each patient.
Findings were: 1) the response of cardiac output and mixed venous lactate was reproducible (p < 0.05) when assessed either the same or the next day; 2) when exercise cardiac output was increased (p < 0.05) by oral amrinone therapy, the increase in lactate was delayed (p < 0.05) to higher levels of muscular work and this was not true when cardiac output was unchanged; and 3) only submaximal anaerobic exercise was symptom limited and associated with an increase in lactate concentration. Thus, the lactate response and anaerobic threshold determination should prove useful to assess the severity of chronic stable heart failure and its response to pharmacologic intervention. The submaximal anaerobic exercise test may provide additional insights into the effort intolerance these patients experience.
- Received February 4, 1985.
- Revision received April 19, 1985.
- Accepted May 15, 1985.
- American College of Cardiology Foundation