Document Detail

Inefficient ventilation and reduced respiratory muscle capacity in congestive heart failure.
MedLine Citation:
PMID:  11005589     Owner:  NLM     Status:  MEDLINE    
The extent and time-course of changes in lung volumes, ventilatory efficiency at rest and during exercise, and respiratory muscle function and their influence on exercise limitation in congestive heart failure (CHF) are unclear. It is unknown whether respiratory muscle function may predict changes in exercise limitation or may be impaired in patients with poor outcome. 145 male patients (54 +/- 1 years) suffering from CHF (NYHA class I-III, mean 2.3 +/- 0.1), with a LVEF of 23 +/- 1%, and a mean peak O2 uptake (VO2peak) 15.0 +/- 0.5 mL X min(-1) X kg(-1), were studied. They were grouped in Weber functional classes A to D according to their VO2peak. Significant increases in ventilatory equivalents for O2 and CO2 (VE/VCO2peak) and in dead space ventilation at rest and during exercise were found with increasing exercise limitation. Moreover, there was a correlation of static and dynamic lung volumes (inspiratory vital capacity, IVC, r = 0.43, P < 0.01), as well as of maximal inspiratory pressure (MIP; r = 0.46, P < 0.01) with VO2peak. Patients who died (n = 26) or were heart transplanted (n = 20) during a follow-up (mean 800 +/- 10 days) had a reduced MIP (6.4 +/- 0.4 kPa) as compared with survivors (n = 82; 9.3 +/- 0.7 kPa, P < 0.01). In a subgroup of 33 patients re-evaluated after six months, individual changes in IVC and VE/CO2peak, but not in MIP, correlated to changes in VO2peak (r = 0.69 and r = 0.72 respectively; P < 0.01). In CHF, exercise limitation is associated with reversible lung restriction and inefficient ventilation at rest and during exercise. Patients with severe CHF have a significant reduction in MIP, a finding that is associated with poor outcome.
F J Meyer; C Zugck; M Haass; L Otterspoor; R H Strasser; W Kübler; M M Borst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Basic research in cardiology     Volume:  95     ISSN:  0300-8428     ISO Abbreviation:  Basic Res. Cardiol.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2001-01-11     Completed Date:  2001-01-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0360342     Medline TA:  Basic Res Cardiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  333-42     Citation Subset:  IM    
Medizinische Klinik und Poliklinik der Universität Heidelberg, Innere Medizin III, Heidelberg, Germany.
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MeSH Terms
Follow-Up Studies
Heart Failure / physiopathology*,  therapy
Lung / physiopathology*
Lung Volume Measurements
Middle Aged
Oxygen Consumption
Respiratory Muscles / physiopathology*
Ventricular Function, Left

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