| Impact of cardiac resynchronisation therapy on adaptation of circulatory and respiratory systems to exercise assessed by cardiopulmonary exercise test in patients with chronic heart failure. | |
| | |
MedLine Citation:
|
PMID: 18473269 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Cardiac resynchronisation therapy (CRT) has become a valuable therapeutic tool in patients with advanced chronic heart failure (CHF). The search for optimal methods for the assessment of CRT efficacy is still underway. AIM: To evaluate the impact of implantation of CRT devices in patients with CHF on adaptation of circulatory and respiratory systems to maximal exercise assessed by cardiopulmonary exercise tests (CPX) and 6-minute walking tests (6MWT). METHODS: We investigated 27 patients (22 males, 5 females, 61.2+/-9.1 years) with a CRT device implanted due to advanced CHF, which resulted from ischaemic or dilated cardiomyopathy. All patients before implantation underwent echocardiography, CPX with expired gas analysis and 6MWT. Investigations were repeated at 3-6 months after CRT implantation. In CPX we evaluated peak oxygen uptake (peak VO2), oxygen pulse, maximal minute ventilation-carbon dioxide production (VE/VCO2 (max)), and its slope (VE/VCO2 slope) and VE/VO2 slope, VO2 in anaerobic threshold (AT), and cardiac and respiratory reserve. In 6MWT we evaluated walking distance and heart rate and blood pressure response to exercise. RESULTS: We noted statistically higher mean peak VO2 after CRT implantation in the studied group: 11.34+/-3.38 vs. 14.56+/-3.99 ml/kg/min (p<0.0001) and 1.01 +/-0.44 vs. 1.4+/-0.55 l/min (p=0.003) and higher values of expired CO2: 1.00+/-0.43 vs. 1.43+/-0.67 l/min (p=0.004). The O2 pulse rose from 9.65+/-3.39 to 13.23+/-5.43 ml/beat (p=0.015). We also observed a significant reduction of VE/VCO2 slope from 42.34+/-13.35 before CRT to 34.77+/-6.04 after CRT (p=0.0196) and a significant decrease of VE/VO2 slope from 41.32 +/-15.46 to 34.01+/-6.27 (p=0.037). VE/VCO2 (max) fell from 58.02+/-15.86 to 50.1+/-13.14 (p=0.009). Patients estimated their dyspnoea on the Borg scale at peak exercise at 4.75+/-0.75 points before CRT and at 3.67+/-1.15 points (p=0.002) after CRT. Patients could walk a longer distance during 6MWT than before CRT (367+/-154.9 vs. 231.1+/-170.3 m, p<0.001). CONCLUSIONS: Cardiac resynchronisation therapy improves exercise tolerance measured by means of CPX and 6MWT, improves respiratory system efficiency and restores its adaptive mechanisms during exercise in patients with advanced CHF. Better exercise adaptation after CRT may be objectively measured with CPX parameters, and correlates with improvement of clinical symptoms. CPX seems to be a very helpful tool in assessing the results of CRT. |
| | |
Authors:
|
Tomasz Chwyczko; Maciej Sterliński; Aleksander Maciag; Bohdan Firek; Andrada Labecka; Agnieszka Jankowska; Marek Kośmicki; Ilona Kowalik; Beata Malczewska; Hanna Szwed |
Related Documents
:
|
1514499 - Ventilatory mechanisms of exercise intolerance in chronic heart failure. 8041679 - Exercise training in patients with congestive heart failure. how to achieve benefits sa... 18054809 - The 12-week progressive quadriceps resistance training improves muscle strength, exerci... 15374149 - Indications and limits of the exercise test in chronic heart failure. 16186059 - Ischemic etiology of heart failure identifies patients with more severely impaired exer... 16893579 - Pulmonary function at peak exercise in patients with chronic heart failure. 1836299 - Gunshot wounds caused by fiocchi anticrime cartridges (plastic bullets). 3341219 - Left ventricular filling in sickle cell anemia. 11001349 - Core temperature measurement during supine exercise: esophageal, rectal, and intestinal... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Kardiologia polska Volume: 66 ISSN: 0022-9032 ISO Abbreviation: Kardiol Pol Publication Date: 2008 Apr |
Date Detail:
|
Created Date: 2008-05-13 Completed Date: 2008-08-26 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0376352 Medline TA: Kardiol Pol Country: Poland |
Other Details:
|
Languages: eng Pagination: 406-12; discussion 413-4 Citation Subset: IM |
Affiliation:
|
2nd Department of Ishaemic Heart Disease, National Institute of Cardiology, Warsaw, Poland. tchwyczko@ikard.pl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Cardiac Pacing, Artificial* Chronic Disease Exercise Test Exercise Tolerance Female Heart Failure / therapy* Humans Male Middle Aged Pacemaker, Artificial Severity of Illness Index Treatment Outcome Walking |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Echocardiographic evaluation of patients with severe heart failure and impairment of intraventricula...
Next Document: Radiotherapy and chemotherapy for oncological diseases--unappreciated risk factors for coronary arte...