Cardiopulmonary exercise test criteria for heart transplantation referral of patients with ambulatory heart failure in the current era

In contemporary practice, a peak VO₂ <12 mL/kg/min alone may not reliably identify patients with HF with sufficiently high short-term mortality to warrant heart transplantation referral. VE/VCO₂ and exercise oscillatory ventilation provide important additional risk stratification, supporting re-evaluation of transplant referral criteria to reflect improved HF management and outcomes.