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Cited by 31Cardiovascular and exercise physiologyCardiac Health and Mental HealthHeart rate and cardiovascular health

Accuracy of estimating exercise prescription intensity in patients with left ventricular systolic dysfunction.

Strzelczyk, Theresa A., Quigg, Rebecca J., Pfeifer, Pamela B., Parker, Michele A., Greenland, Philip·2001·Journal of Cardiopulmonary Rehabilitation
DOI 10.1097/00008483-200105000-00007
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Abstract

PURPOSE: Exercise prescription in patients with left ventricular systolic dysfunction (LVSD) is difficult. Exercising beyond ventilatory threshold (VT) can have negative physiologic effects; therefore, exercise prescribed above VT may be detrimental. A majority of cardiac rehabilitation programs use the Karvonen/heart rate reserve (HRR) method, rating of perceived exertion (RPE), and/or a percentage of oxygen consumption to prescribe exercise intensity. The purpose of this study was to determine if these methods correlate with an exercise intensity below VT in LVSD patients. METHODS: The authors studied 52 patients (37 males, 15 females; age 52 +/- 13 years; left ventricular ejection fraction 27% +/- 8%) who underwent a symptom-limited cardiopulmonary exercise test and reached VT to determine functional capacity and exercise prescription. RESULTS: Peak heart rate (HR) as well as HRR derived minimum (60%), midpoint (70%), and maximum (80%) HR were highly correlated (P < 0.001) with HR at VT. Using these three different HR cutoff formulas from HRR, 15% to 62% of patients were prescribed exercise outside the range of VT-HR +/- 10%. The midpoint (70% HRR) best predicted exercise HR in the VT-HR +/- 10% range (73% of patients). Mean oxygen consumption at VT was 83 +/- 9% of peak oxygen consumption. There was no correlation (P < 0.16) between RPE and VT. CONCLUSIONS: The Karvonen/HRR method failed to estimate HR-VT +/- 10% in a large percentage of patients with LVSD. There was no correlation between RPE and VT. Based on these data, exercise training intensity should ideally be prescribed based on the HR identified at VT using cardiopulmonary exercise testing in patients with LVSD.

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Authors
Strzelczyk, T. A., Quigg, R. J., Pfeifer, P. B., Parker, M. A., & Greenland, P.
Affiliations
Northwestern University (US)
Corresponding author
Strzelczyk, Theresa A.
ORCID
Venue
Journal of Cardiopulmonary Rehabilitation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-05
Volume
21
Issue
3
Pages
158-163
ISSN
0883-9212 (ISSN-L)
DOI
10.1097/00008483-200105000-00007
OpenAlex
W2047791192
Cited by
31
References
20
Citations by year
2025: 1 · 2021: 4 · 2020: 1 · 2019: 2 · 2014: 1 · 2012: 2
FWCI
6.83
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Cardiopulmonary Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
Keywords
left ventricular systolic dysfunction, exercise prescription, exercise intensity, ventilatory threshold, heart rate reserve, rating of perceived exertion, oxygen consumption, cardiopulmonary exercise testing, heart rate, cardiac rehabilitation
MeSH terms
Adult, Aged, Aged, 80 and over, Exercise Test, Exercise Therapy, Female, Heart Rate, Humans, Male, Middle Aged, Prospective Studies, Exercise, Linear Models, Exercise Tolerance, Ventricular Dysfunction, Left

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