TY - JOUR
T1 - Ventilatory and gas exchange abnormalities on exercise in chronic heart failure
AU - Al-Rawas, O. A.
AU - Carter, R.
AU - Richens, D.
AU - Stevenson, R. D.
AU - Naik, S. K.
AU - Tweddel, A.
AU - Wheatley, D. J.
PY - 1995
Y1 - 1995
N2 - The mechanism of breathlessness on exertion in patients with chronic heart failure are still not fully understood. We therefore investigated the effects of ventilatory and gas exchange abnormalities on exercise capacity in chronic heart failure. Exercise testing was performed in 30 patients with exertional breathlessness due to chronic heart failure and in 30 controls, using continuous transcutaneous blood gas monitoring. Maximal symptom-limited oxygen consumption as (V'O2) as a percentage predicted was reduced in patients (45 ± 10%; mean ± SD) compared to controls (87 ± 7). The ventilatory response (minute ventilation/carbon dioxide production (V'E/V'CO2)) was significantly increased in patients compared to controls (39.9 ± 7.7 and 25.9 ± 3.6, respectively). The dead space to tidal volume ratio (VD/VT) was raised in patients compared to controls at rest (0.45 ± 0.04 vs 0.35 ± 0.02, respectively) and this persisted on exertion (0.40 ± 0.05 in patients and 0.20 ± 0.05 in controls). At maximal symptom-limited exercise, V'E/V'CO2 was inversely related to the % prodicted V'O2 in patients, but not in controls (r = -0.62 and r = -0.24, respectively). In patients, V'E/V'CO2 was significantly correlated with VD/VT at maximum exercise (r = 0.82). Patients with chronic heart failure have a significant degree of 'wasted ventilation' on exertion, which is associated with increased ventilatory response. The increased ventilatory response on exertion appears to contribute to exercise limitation in these patients.
AB - The mechanism of breathlessness on exertion in patients with chronic heart failure are still not fully understood. We therefore investigated the effects of ventilatory and gas exchange abnormalities on exercise capacity in chronic heart failure. Exercise testing was performed in 30 patients with exertional breathlessness due to chronic heart failure and in 30 controls, using continuous transcutaneous blood gas monitoring. Maximal symptom-limited oxygen consumption as (V'O2) as a percentage predicted was reduced in patients (45 ± 10%; mean ± SD) compared to controls (87 ± 7). The ventilatory response (minute ventilation/carbon dioxide production (V'E/V'CO2)) was significantly increased in patients compared to controls (39.9 ± 7.7 and 25.9 ± 3.6, respectively). The dead space to tidal volume ratio (VD/VT) was raised in patients compared to controls at rest (0.45 ± 0.04 vs 0.35 ± 0.02, respectively) and this persisted on exertion (0.40 ± 0.05 in patients and 0.20 ± 0.05 in controls). At maximal symptom-limited exercise, V'E/V'CO2 was inversely related to the % prodicted V'O2 in patients, but not in controls (r = -0.62 and r = -0.24, respectively). In patients, V'E/V'CO2 was significantly correlated with VD/VT at maximum exercise (r = 0.82). Patients with chronic heart failure have a significant degree of 'wasted ventilation' on exertion, which is associated with increased ventilatory response. The increased ventilatory response on exertion appears to contribute to exercise limitation in these patients.
KW - exercise
KW - heart failure
KW - pulmonary gas exchange
KW - ventilatory response
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U2 - 10.1183/09031936.95.08122022
DO - 10.1183/09031936.95.08122022
M3 - Article
C2 - 8666096
AN - SCOPUS:0028860665
SN - 0903-1936
VL - 8
SP - 2022
EP - 2028
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 12
ER -