Document Detail


Effects of respiratory muscle unloading on leg muscle oxygenation and blood volume during high-intensity exercise in chronic heart failure.
MedLine Citation:
PMID:  18375714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Blood flow requirements of the respiratory muscles (RM) increase markedly during exercise in chronic heart failure (CHF). We reasoned that if the RM could subtract a fraction of the limited cardiac output (QT) from the peripheral muscles, RM unloading would improve locomotor muscle perfusion. Nine patients with CHF (left ventricle ejection fraction = 26 +/- 7%) undertook constant-work rate tests (70-80% peak) receiving proportional assisted ventilation (PAV) or sham ventilation. Relative changes (Delta%) in deoxy-hemoglobyn, oxi-Hb ([O2Hb]), tissue oxygenation index, and total Hb ([HbTOT], an index of local blood volume) in the vastus lateralis were measured by near infrared spectroscopy. In addition, QT was monitored by impedance cardiography and arterial O2 saturation by pulse oximetry (SpO2). There were significant improvements in exercise tolerance (Tlim) with PAV. Blood lactate, leg effort/Tlim and dyspnea/Tlim were lower with PAV compared with sham ventilation (P < 0.05). There were no significant effects of RM unloading on systemic O2 delivery as QT and SpO2 at submaximal exercise and at Tlim did not differ between PAV and sham ventilation (P > 0.05). Unloaded breathing, however, was related to enhanced leg muscle oxygenation and local blood volume compared with sham, i.e., higher Delta[O2Hb]% and Delta[HbTOT]%, respectively (P < 0.05). We conclude that RM unloading had beneficial effects on the oxygenation status and blood volume of the exercising muscles at similar systemic O2 delivery in patients with advanced CHF. These data suggest that blood flow was redistributed from respiratory to locomotor muscles during unloaded breathing.
Authors:
Audrey Borghi-Silva; Cláudia Carrascosa; Cristino Carneiro Oliveira; Adriano C Barroco; Danilo C Berton; Debora Vilaça; Edgar B Lira-Filho; Dirceu Ribeiro; Luiz Eduardo Nery; J Alberto Neder
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-03-28
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  294     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-09     Completed Date:  2008-08-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H2465-72     Citation Subset:  IM    
Affiliation:
Pulmonary Function and Clinical Exercise Physiology Unit, Division of Respiratory Diseases, Federal University of Sao Paulo, São Paulo, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Volume*
Cardiac Output
Cardiography, Impedance
Chronic Disease
Exercise*
Exercise Tolerance*
Heart Failure / metabolism,  physiopathology*
Hemoglobins / metabolism
Humans
Lactic Acid / blood
Male
Middle Aged
Oximetry
Oxygen Consumption*
Prospective Studies
Pulmonary Ventilation*
Quadriceps Muscle / blood supply,  metabolism,  physiopathology*
Regional Blood Flow
Research Design
Respiratory Muscles / blood supply,  metabolism,  physiopathology*
Spectroscopy, Near-Infrared
Chemical
Reg. No./Substance:
0/Hemoglobins; 50-21-5/Lactic Acid

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


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