Document Detail

Cardiopulmonary exercise testing characteristics in heart failure patients with and without concomitant chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  21095278     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The assessment of aerobic exercise capacity is an important component in the clinical management of patients with heart failure (HF). Although a significant percentage of patients diagnosed with HF also present with chronic obstructive pulmonary disease (COPD) comorbidity, the combined impact of these chronic conditions on the aerobic exercise response is unknown and is therefore the purpose of the present investigation.
METHODS: Sixty-nine subjects with HF and COPD were matched to 69 subjects solely diagnosed with HF according to age, sex, and HF etiology. All subjects underwent resting pulmonary function and diffusion capacity testing, echocardiography with tissue Doppler imaging, and cardiopulmonary exercise testing (CPX).
RESULTS: Subjects with COPD comorbidity had significantly lower pulmonary function testing and diffusion capacity values versus HF alone (P < .05). In addition, subjects with both HF and COPD had significantly higher pulmonary artery systolic pressures (51.9 ± 9.0 vs 37.0 ± 7.8 mm Hg, P < .001) as assessed by pulsed Doppler echocardiography. Cardiopulmonary exercise testing revealed a significantly poorer response in subjects with HF and COPD by all variables that were analyzed, including peak oxygen consumption (12.1 ± 4.3 vs 16.3 ± 4.3 mL kg⁻¹ min⁻¹, P < .001), minute ventilation/carbon dioxide production slope (42.7 ± 7.4 vs 33.3 ± 6.6, P < .001) and heart rate recovery at 1 minute (12.1 ± 2.5 vs 14.2 ± 2.9 beats, P < .001).
CONCLUSIONS: Patients with HF and the comorbidity of COPD have significantly impaired CPX responses. This novel finding may impact the clinical interpretation of CPX data in patients with HF who also present with this chronic pulmonary condition.
Marco Guazzi; Jonathan Myers; Marco Vicenzi; Daniel Bensimhon; Paul Chase; Sherry Pinkstaff; Ross Arena
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  160     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  900-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Cardiopulmonary Laboratory, Cardiology Division, University of Milano, San Paolo Hospital, Milano, Italy.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Aldosterone Antagonists / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Blood Pressure
Disease Progression
Diuretics / therapeutic use
Drug Therapy, Combination
Echocardiography, Doppler, Pulsed
Exercise Test
Exercise Tolerance / physiology*
Follow-Up Studies
Heart Failure / complications,  drug therapy,  physiopathology*
Middle Aged
Pulmonary Disease, Chronic Obstructive / complications,  drug therapy,  physiopathology*
Respiratory Function Tests
Severity of Illness Index
Ventricular Function, Left / physiology
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Aldosterone Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics

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