Document Detail


Airflow limitation and breathing strategy in congestive heart failure patients during exercise.
MedLine Citation:
PMID:  12740509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Congestive heart failure (CHF) patients experience dyspnea on exertion and therefore have decreased exercise tolerance. OBJECTIVE: This study explores the hypothesis that stable New York Heart Association (NYHA) class III CHF patients without a history of pulmonary disease exhibit airflow limitation with increasing exercise. METHODS: We characterized flow limitations and breathing reserves at baseline, during exercise before anaerobic threshold (pre-AT), and after anaerobic threshold (post-AT) in CHF patients and normal subjects. Data were collected in the form of maximal flow volume loops and subsequent tidal flow volume loops at baseline and during exercise. Expiratory flow limitation was expressed as percent of tidal volume that corresponded with overlap of the tidal flow volume loops and maximal flow volume loops during expiration. The area directly between the maximum flow volume loops and the tidal flow volume loops during the expiratory phase is expressed as expiratory flow volume reserve (EFVR). RESULTS: CHF patients experienced expiratory flow limitation during exercise (pre-AT and post-AT) that was significantly increased compared to baseline and to normal subjects at similar exercise levels (CHF, baseline 8.5 +/- 7, pre-AT 37 +/- 10, post-AT 38 +/- 8%, n = 9, p < 0.05). Both CHF patients and normal subjects increased EFVR during exercise, but only the normal subjects increased EFVR to a significantly different value at post-AT exercise levels (normal subjects, 9.5 +/- 2, 11 +/- 2, 32 +/- 4%, n = 7, p < 0.05). Both CHF patients and normal subjects increased end inspiratory lung volume (EILV) during exercise, but only the normal subjects significantly increased EILV at post-AT exercise levels (normal subjects, 49 +/- 4, 55 +/- 5, 76 +/- 4%, p < 0.05). Inspiratory capacity (IC)/forced vital capacity (FVC) ratios were increased in CHF patients compared to normal subjects. However, IC/FVC values did not change during exercise in either group. CONCLUSIONS: CHF patients cannot utilize their full respiratory capacity during exercise secondary to expiratory flow limitation and an inability to increase EILV and EFVR.
Authors:
C Andrew Schroeder; David L Balfe; Steven S Khan; Zab Mohsenifar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respiration; international review of thoracic diseases     Volume:  70     ISSN:  0025-7931     ISO Abbreviation:  Respiration     Publication Date:    2003 Mar-Apr
Date Detail:
Created Date:  2003-05-12     Completed Date:  2003-09-03     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0137356     Medline TA:  Respiration     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  137-42     Citation Subset:  IM    
Copyright Information:
Copyright 2003 S. Karger AG, Basel
Affiliation:
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. schroederc@cshs.org
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MeSH Terms
Descriptor/Qualifier:
Exercise / physiology*
Exercise Tolerance / physiology
Female
Forced Expiratory Flow Rates
Forced Expiratory Volume
Heart Failure / physiopathology*
Humans
Male
Middle Aged
Respiratory Mechanics*
Comments/Corrections
Comment In:
Respiration. 2003 Mar-Apr;70(2):133-4   [PMID:  12740507 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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