Oxygen uptake kinetics in chronic heart failure: clinical and physiological aspects

One of the hallmark symptoms of patients with chronic heart failure (CHF) is exercise intolerance. Therefore, exercise testing has become an important tool for the evaluation and monitoring of heart failure. Whereas the maximal aerobic capacity (peak VO2) is a reliable indicator of the severity and prognosis of heart failure, submaximal exercise parameters may be more closely related to the ability to perform daily activities. As such, oxygen (O2) uptake kinetics, describing the rate change of O2 uptake during onset or recovery of submaximal constant-load exercise (O2 onset and recovery kinetics, respectively), have been shown to be useful parameters for objectively evaluating the functional capacity of CHF patients. However, their evaluation in this population is not a routine part of daily clinical practice. Possible reasons for this include a lack of standardisation of the assessment methodology and a limited number of studies evaluating the clinical use of O2 uptake kinetics in CHF patients. In addition, the pathophysiological mechanisms underlying the delay in O2 uptake kinetics in these patients are not completely understood. This review discusses the current literature on the clinical potency and physiological determinants of O2 uptake kinetics in CHF patients and provides directions for future research. (Neth Heart J 2009;17:238–44.)