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Diagnostic exercise physiology in chronic heart failure
D P Francis, L C Davies, A J S CoatsRoyal Brompton
Hospital and National Heart & Lung Institute, Imperial College of
Science, Technology and Medicine, Sydney Street, London SW3 6NP,
UK
Correspondence to: Dr Francis d.francis@cheerful.com
Accepted 20 February
2001
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Chronic heart failure (CHF) carries a mortality higher than many forms of cancer,1 as well as impairing quality of life and causing many acute hospital admissions.2 Despite the recent improvements in medical treatment, prevalence and mortality of CHF seem set to remain high.3
The convention of defining CHF in terms of symptoms, clinical
signs, and findings on investigation has certain limitations. Firstly,
although the principal symptoms
breathlessness and fatigue on
exercisemay be pronounced, they overlap with those of patients with
respiratory disease and can even be reported by normal subjects. Secondly, signs of fluid retention do not always persist with optimal
medical treatment and when they are found they do not necessarily
signify cardiac failure.4 Thirdly, while imaging investigations may identify abnormalities in cardiac function at rest,
there are difficulties in obtaining an objective, unifying measurement
that may be useful across all forms of heart failure. Lastly, none of
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