Cardiopulmonary Function Assessment Scores (CPET)

Cardiopulmonary Exercise (HF) Risk Score Calculator

Clinical calculation support · Verify results before clinical use

CPET prognostic marker assessment

Enter the patient's cardiopulmonary exercise test findings to review established prognostic markers. This tool does not generate a validated composite risk score.

CPETHF

Age (years)

Recorded as clinical context only; no age points are assigned.

Peak VO₂ (mL/kg/min)

Use a technically adequate CPET result and interpret in the context of effort, treatment, body composition, and the clinical question.

VE/VCO₂ slope

Enter the slope reported by the CPET laboratory, not a single VE/VCO₂ ratio.

Previous heart failure hospitalization

Clinical context only; this variable is not weighted into an unvalidated score.

No known prior hospitalization

Prior hospitalization

Assessment summary

Enter Peak VO₂ and/or VE/VCO₂ slope to see marker-specific context. No composite score or individual mortality probability is calculated.

Peak VO₂

Not entered

A commonly used transplant-evaluation threshold is ≤12 mL/kg/min in patients receiving beta-blockers; ≤14 may be considered when beta-blockers are not tolerated. Apply current specialist guidance and the full clinical context.

VE/VCO₂ slope

Not entered

A slope above 35 is associated with worse prognosis in HF and may be particularly useful when exercise is submaximal. It is not a standalone individual risk estimate.

Age

Not entered

Age is part of overall prognostic assessment but is not assigned points by this tool.

Hospitalization history

No known prior hospitalization

A prior HF admission should be considered alongside symptoms, congestion, biomarkers, echocardiography, treatment optimization, and the overall clinical trajectory.

Clinical context

Cardiopulmonary exercise testing (CPET) provides complementary prognostic information in heart failure. Peak VO₂ and VE/VCO₂ slope are established markers, but their interpretation depends on patient characteristics, effort adequacy, treatment, and the clinical decision being considered.

How to interpret these markers

Marker	Clinical context	Important limitation
Peak VO₂	Values around ≤12 mL/kg/min during beta-blocker therapy, or ≤14 mL/kg/min when beta-blockers are not tolerated, are commonly considered in advanced HF/transplant assessment.	Not a universal mortality cutoff; consider respiratory exchange ratio, percent-predicted VO₂, sex, age, and the applicable guideline.
VE/VCO₂ slope	A value >35 is associated with higher risk in HF cohorts and can retain prognostic value when peak effort is submaximal.	Risk is continuous and population-dependent; do not infer a specific mortality percentage from the slope alone.
Prior HF admission	Useful clinical history when assessing disease trajectory and advanced HF risk.	Not included in a validated weighted score in this calculator.

Practical reminders

Confirm CPET quality and whether effort was adequate before interpreting peak VO₂.
Integrate findings with NYHA class, LVEF, biomarkers, hemodynamics, treatment optimization, comorbidities, and trajectory.
Refer to an advanced heart failure team when the overall clinical picture suggests advanced disease; do not use a single threshold as the sole decision criterion.

References

Peled Y, Ducharme A, Kittleson M, et al. International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates—2024. J Heart Lung Transplant. 2024;43(10):1529–1628.e54. doi:10.1016/j.healun.2024.05.010. Guideline DOI.

Arena R, et al. Validation of a cardiopulmonary exercise test score in heart failure. J Am Coll Cardiol. Original CPET score uses a different set of variables and weighting; it does not validate the legacy four-variable algorithm in the original Appcardio file. Publisher record.

Guazzi M, et al. Role of cardiopulmonary exercise testing in clinical stratification in heart failure. European Journal of Heart Failure. Position paper from the Heart Failure Association of the ESC. Publisher record.

Albouaini K, et al. Cardiopulmonary exercise testing in patients with chronic heart failure: prognostic comparison from peak VO₂ and VE/VCO₂ slope. PMCID: PMC2908890. Full text.

Clinical disclaimer: This page summarizes selected CPET markers and does not calculate a validated composite risk score or an individualized mortality probability. It is intended for clinician support and education, not as a substitute for current guidelines, specialist assessment, or clinical judgment. The original weighted algorithm was removed because its thresholds, point weights, and risk categories could not be verified from the citation supplied with the legacy code.