| Airflow limitation and breathing strategy in congestive heart failure patients during exercise. | |
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MedLine Citation:
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PMID: 12740509 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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C Andrew Schroeder; David L Balfe; Steven S Khan; Zab Mohsenifar |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Respiration; international review of thoracic diseases Volume: 70 ISSN: 0025-7931 ISO Abbreviation: Respiration Publication Date: 2003 Mar-Apr |
Date Detail:
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Created Date: 2003-05-12 Completed Date: 2003-09-03 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0137356 Medline TA: Respiration Country: Switzerland |
Other Details:
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Languages: eng Pagination: 137-42 Citation Subset: IM |
Copyright Information:
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Copyright 2003 S. Karger AG, Basel |
Affiliation:
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Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. schroederc@cshs.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Exercise
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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:
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Respiration. 2003 Mar-Apr;70(2):133-4
[PMID:
12740507
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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