| Enhanced ventilatory response to exercise in patients with chronic heart failure and central sleep apnea. | |
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MedLine Citation:
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PMID: 12695297 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In patients with chronic heart failure (CHF), central sleep apnea (CSA) and enhanced ventilatory response (VE/VCO2 slope) to exercise are common. Both breathing disorders alone indicate poor prognosis in CHF. Although augmented chemosensitivity to CO2 is thought to be one important underlying mechanism for both breathing disorders, it is unclear whether both breathing disorders are related closely in patients with CHF. METHODS AND RESULTS: We investigated 20 CHF patients with clinically important CSA (apnea-hypopnea-index (AHI), number of episodes per hour >or=15) and 10 CHF patients without CSA. Patients with and without CSA did not differ with respect to exercise capacity (peak VO2, 63.4+/-3.4% versus 60.8+/-4.4% of predicted value; P=0.746) and left ventricular ejection fraction (LVEF, 31+/-2% versus 31+/-3%; P=0.948). The AHI was not correlated with exercise capacity (peak VO2, percent of predicted value; P=0.260) and LVEF (percent, P=0.886). In contrast, the positive correlation of the VE/VCO2 slope, determined by cardiopulmonary exercise testing, with the AHI was highly significant (P<0.001). The VE/VCO2 slope was significantly increased in patients with CSA compared with those without CSA (29.7 versus 24.9; P<0.001). CONCLUSIONS: The ventilatory response to exercise is significantly augmented in CHF patients with CSA compared with those without. In contrast to peak VO2 and LVEF, the VE/VCO2 slope is strongly related to the severity of CSA in patients with CHF, which underscores an augmented chemosensitivity to CO2 as a common underlying pathophysiological mechanism. |
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Authors:
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Michael Arzt; Martina Harth; Andreas Luchner; Frank Muders; Stephan R Holmer; Friedrich C Blumberg; Günter A J Riegger; Michael Pfeifer |
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Publication Detail:
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Type: Journal Article Date: 2003-04-14 |
Journal Detail:
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Title: Circulation Volume: 107 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-22 Completed Date: 2003-04-25 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1998-2003 Citation Subset: AIM; IM |
Affiliation:
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Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Germany. michael.arzt@klinik.uni-regensburg.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Chronic Disease Exercise Test Heart Failure / complications, physiopathology* Humans Linear Models Oxygen Consumption Physical Exertion* Predictive Value of Tests Pulmonary Ventilation* ROC Curve Sleep Apnea, Central / complications, diagnosis*, physiopathology* Sleep Stages Stroke Volume |
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