Cardiopulmonary exercise Test – The Revolving door of left ventricular Assist devices in heart Failure

Abstract The Prevalence of heart failure has an increasing tendency in the last years. Either Heart failure with reduced ejection fraction (HFrEF) or with preserved ejection fraction (HFpEF), the treatment depends on the severity, cause and symptoms. In Case of HFrEF, careful evaluation of patient is essential for proper diagnosis, risk stratification and treatment, which should always be individualistic. Except from daily measurements, medical treatment and eventually implantation of implantable cardioverter Defibrillator (ICD) or cardiac resynchronization Therapy (CRT), implantation of left ventricular assist device (LVAD) belongs also to therapeutic armamentarium. Other than invasive procedures, which are required for the evaluation of every patient with HFrEF, Cardiopulmonary exercise Test emerges as one of the most effective non-invasive method for diagnosis, risk stratification and treatment strategy for these patients. Cardiopulmonary exercise test can provide means for a critical evaluation of cardiovascular system. One of the most important Variables is the maximal oxygen Consumption (peak VO2). Its high predictive and prognostic power makes peak VO2 essential for the evaluation of patients as candidates, not only for LVAD-Implantation, but also for Explantation. Furthermore, regarding cardiac Rehabilitation and exercise protocols, robust literature supports a follow-up of LVAD-Patients by means of CPET.