In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ACNAP Silver Members, Fellows of the ESC and Young combined Members

Diagnostic and prognostic value of lactate threshold and PH - Threshold determination during cardiopulmonary testing in patients with chronic heart failure

Session Poster session 1

Speaker Victoria Galenko

Event : EuroHeartCare 2016

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure
  • Session type : Poster Session

Authors : T Lelyavina (Saint Petersburg,RU), VL Galenko (Saint Petersburg,RU), MY Sitnikova (Saint Petersburg,RU)

T Lelyavina1 , VL Galenko1 , MY Sitnikova1 , 1Almazov Federal Center of Heart Blood & Endocrinology - Saint Petersburg - Russian Federation ,

European Journal of Cardiovascular Nursing ( 2016 ) 15 ( Supplement ), S24

Objective: lactate threshold and pH-threshold determination during cardiopulmonary testing (CPET) and evaluate their diagnostic and prognostic value in patients with chronic heart failure. Methods: The study included 58 HF patients with NYHA class II-IV, who have performed CPET on treadmill using equipment “Oxycon PRO”, Jaeger, Germany. Individual exercise test protocol (ramp protocol) was created for every participant. The cubital venous catheter was installed in all subjects before exercise test. Blood samples were taken at baseline and at 1-minute intervals during test. PH, lactate and HCO3- concentration were estimated using analyzer i-STAT, cartridge CG4 (Abbot, USA). Lactate threshold (LT) and pH-threshold (pH-T) were determined by changes in pH and lactate levels in correlation with dynamics of oxygen uptake (VO2), carbon dioxide output (VCO2), minute ventilation (VE), ventilatory equivalent of carbon dioxide (VE/VCO2), respiratory exchange ratio (RER). Respiratory compensation point (RCP) was determined, when ventilation dramatically increase relative VE/VCO2.
Results: In HF pts with NYHA class II level of physical performance was significantly higher than in patients NYHA class III and IV. However, during exercise in all HF patients were observed similar physiological stages, but with varying of exercise intensity. In HF patient with NYHA class IV, exercise was stopped before reaching of RCP in connection with the development shortness of breath, weakness, tiredness, fatigue in the legs 8-9/10 Borg scale. Among HF patients with NYHA class III RCP reached 12 (36%) of people, among patients with class II - 14 (82%). The 95% confidence intervals (CI) for the VO2peak, RCP, pH-T and LT in II, III and IV NYHA class are follows: in HF patients with NYHA class II - 17.4 to 18.2, 16.3 to 17.2, 14.7 to 15.3 and 9.7 to 10.1; NYHA class III - 13.5 to 14.3, 12.2 to 12.8, 11.4 to 11.8 and 8.2 to 8.6; NYHA class IV - 8.6 to 10.6 for VO2peak, 8.1 to 9.7 for VO2pH-T, 5.7 to 7.5 for VO2LT. HF NYHA class correlated with VO2LT, VO2pH-T and VO2RCP, r=−0.7, p<0.01, r=−0.5, p<0.01 and r=−0.4, p<0.01, respectively. Patients were observed in the average 21.4 of +/ − 1.5 months (6-48). For the specified period in the study group died 15 HF patients (25%) with III-IV FC. We observed the following correlations: the survival and VO2LT - r=0.8, p<0.05; survival and VO2??-T - r=0.5, p<0.05; survival and VO2RCP - r=0.2, p<0.07.
Conclusion: In HF patients with NYHA class II-IV significant diagnostic and prognostic markers are content VO2 at lactate threshold and pH-threshold, especially at the lactate threshold.

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are