| Causes of breathing inefficiency during exercise in heart failure. | |
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MedLine Citation:
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PMID: 20932466 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with heart failure (HF) develop abnormal pulmonary gas exchange; specifically, they have abnormal ventilation relative to metabolic demand (ventilatory efficiency/minute ventilation in relation to carbon dioxide production [V(E)/VCO₂]) during exercise. The purpose of this investigation was to examine the factors that underlie the abnormal breathing efficiency in this population. METHODS AND RESULTS: Fourteen controls and 33 moderate-severe HF patients, ages 52 ± 12 and 54 ± 8 years, respectively, performed submaximal exercise (∼65% of maximum) on a cycle ergometer. Gas exchange and blood gas measurements were made at rest and during exercise. Submaximal exercise data were used to quantify the influence of hyperventilation (PaCO₂) and dead space ventilation (V(D)) on V(E)/VCO₂. The V(E)/VCO₂ relationship was lower in controls (30 ± 4) than HF (45 ± 9, P < .01). This was the result of hyperventilation (lower PaCO₂) and higher V(D)/V(T) that contributed 40% and 47%, respectively, to the increased V(E)/VCO₂ (P < .01). The elevated V(D)/V(T) in the HF patients was the result of a tachypneic breathing pattern (lower V(T), 1086 ± 366 versus 2003 ± 504 mL, P < .01) in the presence of a normal V(D) (11.5 ± 4.0 versus 11.9 ± 5.7 L/min, P = .095). CONCLUSIONS: The abnormal ventilation in relation to metabolic demand in HF patients during exercise was due primarily to alterations in breathing pattern (reduced V(T)) and excessive hyperventilation. |
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Authors:
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Paul R Woods; Thomas P Olson; Robert P Frantz; Bruce D Johnson |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-06-16 |
Journal Detail:
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Title: Journal of cardiac failure Volume: 16 ISSN: 1532-8414 ISO Abbreviation: J. Card. Fail. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-11 Completed Date: 2011-02-15 Revised Date: 2013-05-27 |
Medline Journal Info:
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Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
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Languages: eng Pagination: 835-42 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN 55902, USA. woods.paul@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Carbon Dioxide
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metabolism Data Interpretation, Statistical Exercise Test Exercise Tolerance Female Heart Failure* / blood, complications, physiopathology Humans Hyperventilation* / blood, diagnosis, etiology Male Middle Aged Oxygen / metabolism Oxygen Consumption / physiology Respiration Respiratory Function Tests / methods* Respiratory Insufficiency / blood, complications, diagnosis Respiratory Rate / physiology Severity of Illness Index Statistics as Topic |
| Grant Support | |
ID/Acronym/Agency:
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HL71478/HL/NHLBI NIH HHS; R01 HL071478-07/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
| Comments/Corrections | |
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