Reproducibility of a simple cardiac output response to stress test to diagnose and monitor heart failure in a primary care setting

Djordje Jakovljevic; Sarah J Charman; Nduka C Okwose; Renae J Stefanetti; Kristian Bailey; Jane Skinner; Mike Scott; Jonathan Mant; FD Richard Hobbs; Guy A MacGowan

doi:10.3399/bjgp18X697109

Abstract

Background We developed a simple non-invasive Cardiac Output Response to Stress (CORS) Test to improve diagnosis and monitoring of heart failure in primary care.

Aim The aim of the present study was to assess test-retest reproducibility of the CORS test.

Method Thirty-two healthy volunteers (age, 64±10, female n=18) were recruited. Cardiac output was measured continuously using bioreactance method in supine and standing position, and during a two 3-min stages of a step-exercise protocol (10 and 15 steps per minute) using a 15-cm height bench. The CORS test was performed twice i.e. Test 1 and Test 2.

Results Cardiac output and stroke volume were not significantly different between the two tests at supine (6.2±1.4 versus 6.3±1.7 L/min, P = 0.84; 102±24 versus 108±32 ml/beat, P = 0.36), standing (5.7±2.1 versus 5.7±1.9 L/min, P = 0.99; 82±32 versus 83±29 ml/beat, P = 0.93), stage one step-exercise (8.5± 1.8 versus 8.2±1.9 L/min, P = 0.56; 104±26 versus 104±27 ml/beat, P = 0.99) and stage two step-exercise (9.9±1.7 versus 9.6±2.0 L/min, P = 0.51; 109±29 versus 111±26 ml/beat, P = 0.76). There was a significant positive relationship between Test 1 and Test 2 cardiac outputs (r=0.92, P<0.01 with coefficient of variation of 7.1%). The mean difference in cardiac output (with upper and lower limits of agreement) between Test 1 and Test 2 was 0.1 (−1.9 to 2.1) L/min, combining rest and exercise data.

Conclusion The CORS test demonstrates acceptable reproducibility and can potentially be used in primary care to identify and monitor heart failure.

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Reproducibility of a simple cardiac output response to stress test to diagnose and monitor heart failure in a primary care setting

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