Clinical Value of CPET in the Objective and Quantitative Assessment of Cardiopulmonary Function and Prognosis in Patients with Chronic Heart Failure

Alimujiang·Abulaiti

doi:10.12102/j.issn.1672-1349.2025.14.020

Abstract：Objective: To analyze the value of cardiopulmonary exercise testing (CPET) in objectively and quantitatively assessing changes in pulmonary and cardiac function and prognosis in patients with chronic heart failure (CHF) after cardiac rehabilitation. Methods: A total of 70 CHF patients admitted to our department from July 2022 to May 2023 were selected. All patients received cardiac rehabilitation guided by CPET. Changes in overall pulmonary and cardiac function in CHF patients before rehabilitation, one month after rehabilitation, and three months after rehabilitation were compared. The six-month prognosis (including rehospitalization due to heart failure and cardiovascular death) was followed up, and the relationship between parameter changes and prognosis was analyzed. Results: One month and three months after rehabilitation, the peak oxygen uptake (VO2peak), anaerobic threshold oxygen uptake (VO2 AT), peak oxygen pulse (PeakVO2/HR), peak power (Wattpeak), oxygen ventilation efficiency peak plateau (OUEP), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximum voluntary ventilation (MVV) were higher than before rehabilitation. Moreover, these parameters were higher three months after rehabilitation than one month after rehabilitation (P < 0.05). During the six-month follow-up, 19 patients were readmitted due to CHF and 5 patients died of cardiovascular causes, resulting in an adverse event rate of 34.29% (24/70). Comparing the changes in VO2peak and VO2AT between the good prognosis group and poor prognosis group one month and three months after rehabilitation showed statistically significant differences (P < 0.05). Three months after rehabilitation, the area under the receiver operating characteristic (ROC) curve (AUC) for predicting poor prognosis using VO2peak and VO2AT was greater than 0.70, indicating good predictive performance. The optimal cutoff values for VO2peak and VO2AT were 21.36 mL/(min·kg) and 16.87 mL/(min·kg), respectively. Conclusion: CPET can objectively and quantitatively assess the overall pulmonary and cardiac function level in CHF patients, and the CPET parameters can be used to determine the risk of adverse prognosis.