| Central and peripheral components of chronic heart failure: determinants of exercise tolerance. | |
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MedLine Citation:
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PMID: 10402045 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study sought to determine the relationship between myocardial dysfunction and peripheral haemodynamic disorders to exercise intolerance in patients with chronic heart failure (CHF). Seventeen patients with mild to moderate CHF (peak oxygen consumption (VO2) >16 ml/min/kg) and 13 with severe CHF (peak VO2 <16 ml/min/kg) underwent invasive (Swan-Ganz) cardiopulmonary exercise testing and forearm venous occlusion plethysmography at rest and during maximal dilatation in reactive hyperaemia. There was a shift from central to peripheral haemodynamic factors limiting exercise, suggesting an increasing importance of peripheral factors in parallel to the progression of CHF. In mild to moderate CHF peak VO2 was closely related to central haemodynamics (r = 0.57 for cardiac index at rest; r = 0.76 for cardiac index at maximal workload; r = -0.54 for right arterial pressure at maximal workload; all p<0.05) and poorly correlated with peripheral haemodynamics (blood flow, vascular resistance and venous tone). In contrast, in severe CHF peak VO2 was closely related to peripheral haemodynamic factors (r = 0.79 for forearm blood flow; r = -0.82 for vascular resistance; r = -0.77 for venous tone; all p<0.05) and less to central ones. Thus, exercise tolerance of patients with mild to moderate CHF is predominantly determined by central haemodynamic factors, notably by the cardiac index. In severe CHF peripheral factors assume ever greater importance in the determining of exercise capacity. |
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Authors:
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V G Florea; V Y Mareyev; A A Achilov; M I Popovici; A J Coats; Y N Belenkov |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: International journal of cardiology Volume: 70 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-08-12 Completed Date: 1999-08-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: IRELAND |
Other Details:
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Languages: eng Pagination: 51-6 Citation Subset: IM |
Affiliation:
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Cardiology Research Centre, Moscow, Russia. vioflor@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiac Output Chronic Disease Coronary Disease / physiopathology* Disease Progression Exercise Tolerance / physiology* Forearm / blood supply Heart Failure / physiopathology* Hemodynamics Humans Male Middle Aged Oxygen Consumption Plethysmography Regional Blood Flow |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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