Document Detail


Enhanced ventilatory response to exercise in patients with chronic heart failure and central sleep apnea.
MedLine Citation:
PMID:  12695297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2003-04-14
Journal Detail:
Title:  Circulation     Volume:  107     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-22     Completed Date:  2003-04-25     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1998-2003     Citation Subset:  AIM; IM    
Affiliation:
Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Germany. michael.arzt@klinik.uni-regensburg.de
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MeSH Terms
Descriptor/Qualifier:
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

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


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