425 Evaluation of Patients with Dyspnea with Utilization of Submaximal Exercise Study with SHAPE -HF™ Test Shows Benefits of Cost Saving and Better Patient Care

Abstract

Purpose: Dyspnea is the most common marker for respiratory and cardiovascular disorders. Patients with dyspnea undergo intensive testing before proper diagnosis can be established. Hypothesis We evaluated if a single test such as sunmaximal exrsice study (SHAPE HFTM) can be utilize as a tool to establish causes of dyspnea and trigger proper pulmonary or cardiac follow up. Methods and Materials: All patient available for exercise testing in underwent Sub Maximal Heart and Pulmonary Evaluation (SHAPE_-HF TM) test. The tested using a standard protocol that included 2 minute rest, three minutes step exercise and 1 minute recovery. The report in addition to basic demographic and vitals included : breathing efficiency slope (VE/VCO2), O2 uptake efficiency slope, O2 pulse (VO2 /HR) and peak RER. Retrospective review of patients charts was done to calculate cost and number of previous tests and consultations performed in each patient before visit in our clinic. Results: We performed 124 tests. The mean age of population was 56 . 10 years. The most common diagnosis was chronic obstructive pulmonary disease (72 cases), and congestive heart failure (CHF) (52 cases). All patients CHF were NYHA class III. All patients were able to finish study, the mean VE/CO2 was 44 (normal 26). The mean O 2 uptake efficiency slope range from 0.8 to 1,2 (normal 2.12). The peak O2 pulse was 6.3. The trigering for evaluation for pulmonary hypertension (primary and secondary) was done in 30 cases with the right heart catheterizations confirming diagnosis. The cost of SHAPE test was $204 00. The mean charges for patients previous tests ranged from $1500.00 to $ 4000.00. Conclusions: We found that in outpatient clinical practice submaximal exercise with SHAPE HF TM test was easy and safe to perform and cost effective. The results allowed us to establish precise diagnosis and follow up care. Further studies are needed to evaluate this test as tool for screeening patients with dyspnea.