This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Symptom-limited exercise testing with ventilatory expired gas is an accepted form of evaluation in the heart failure population. There are a number of parameters, beyond peak VO2, which appear to hold clinical value. The purpose of this study is to improve the interpretive skills of clinicians responsible for analysis of this type of data and to apply it in a way that is beneficial to the care of the patient with heart failure, and to prospectively build a database of key variables from standard of care exercise tests in patients with HF and simultaneously assess their individual and combined ability to predict cardiac related hospitalization and mortality over a one-year period. The value of exercise testing in the heart failure (HF) population is well established. Guidelines for exercise testing put forth be the American College of Cardiology and American Heart Association categorize exercise testing with ventilatory expired gas analysis in the HF population as a class I recommendation which is based upon a large number of well controlled investigations supporting its use. To date, there has not been an investigation, which has compared the prognostic significance of all promising ventilatory expired gas parameters simultaneously. Additionally, little work has been done in examining the ability of these parameters to predict outcomes other than mortality. Given that HF is the primary hospital diagnostic related group among Medicare patients, analysis of measures predicting hospitalization in this population seems warranted. Subjects are required to participate in an exercise test with ventilatory expired gas analysis as part of their standard of care as determined by their cardiologist/physician. The session consists of collecting necessary background information, completing all paperwork and written evaluation tools, and undergoing a symptom-limited exercise test. These procedures are identical to what would be performed clinically without a research agenda. The only addition will be the construction of a database to determine the prognostic ability of exercise testing data.
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