Clinical Application of Cardiac Output During Ramp Exercise Calculated Using the Fick Equation : Comparison With the 2-Stage Bicycle Ergometer Exercise Protocol in the Supine Position

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The purpose of this study was to clarify whether the direct Fick method is applicable to the measurement of cardiac output (Q) during ramp exercise. Twelve patients with chronic heart failure underwent both a ramp exercise test and a steady-state exercise test. Oxygen intake (VO_2), arterial oxygen saturation and mixed venous oxygen saturation were continuously measured using a pulse oximeter and a fiberoptic catheter, and the arteriovenous oxygen difference (a-v O_2 diff) and Q were calculated. Both VO_2 and a-v O_2 diff were significantly lower in the ramp protocol than in the steady-state protocol when they were compared at the same workload. However, the VO_2 vs Q relationship and the VO_2 vs a-v O_2 diff relationship were very similar in the 2 protocols. The difference between Q measured during steady-state exercise and Q calculated at the matched VO_2 during ramp exercise was small (3.7±7.0% and 5.6±6.6%). The results indicate that, clinically, Q measured by the direct Fick method with simultaneous measurement of VO_2 and a-v O_2 diff during ramp exercise is a good substitute for the true Q measured by the steady-state protocol. We conclude that Fick Q is applicable to ramp exercise.
社団法人日本循環器学会の論文
1997-05-20