Martin, D., O'Doherty, A. and Imray, C. (Chris) (2012) The prognostic value of cardiopulmonary exercise testing in vascular surgery patients. European Journal of Vascular and Endovascular Surgery, Vol.44 (No.4). p. 457. doi:10.1016/j.ejvs.2012.06.029 ISSN 1078-5884.

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Abstract

We read with considerable interest the article by Young et al. published recently in this journal.1 The article described a systematic review of the literature relating to the use of preoperative cardiopulmonary exercise testing (CPET) in patients undergoing vascular surgery. The eight authors of this systematic review reported results from six studies (although this was stated as seven in the abstract). Of those six studies, the largest three [2], [3] and [4] all reported that CPET was a useful predictor of outcome in patients undergoing abdominal aortic aneurysm repair. We note that one of these, by McEnroe and Wilson,3 was actually a retrospective audit of 119 patients, presented in abstract form at a scientific meeting, thus fulfilling the authors' criteria for ‘grey literature’. The other three peer-reviewed studies mentioned in the review were all of 30 or fewer patients and were therefore likely to lack the power to detect the influence of CPET results on patient outcome. One of the studies, Kothmann et al.,5 did not even report outcome data and was designed as a test of inter-individual (test–retest) variability; it is difficult to understand why such a study was included in a systematic review of this nature. All of the ‘grey literature’ articles listed in the article (eight studies) supported the use of CPET in the setting of AAA repair. Another recent publication, not included in this review article, further advocates the role of CPET in the setting of aortic aneurysm repair, reporting that in the 185 patients in whom there was outcome data, anaerobic threshold (AT) was the only predictor of survival at 30 days, 90 days and 1 year

Item Type:	Journal Article
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	European Journal of Vascular and Endovascular Surgery
Publisher:	Elsevier Ltd
ISSN:	1078-5884
Official Date:	2012
Dates:	Date Event 2012 Published
Volume:	Vol.44
Number:	No.4
Page Range:	p. 457
DOI:	10.1016/j.ejvs.2012.06.029
Status:	Peer Reviewed
Publication Status:	Published

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