Document Detail


Lung-heart interaction as a substrate for the improvement in exercise capacity after body fluid volume depletion in moderate congestive heart failure.
MedLine Citation:
PMID:  7572657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated exercise capacity after fluid depletion in patients with moderate congestive heart failure (CHF). Twenty-one patients underwent ultrafiltration (mean volume +/- SEM: 1,770 +/- 135 ml). Echocardiography, tests of pulmonary function, and a cardiopulmonary exercise test with hemodynamic and esophageal pressure monitoring were performed before ultrafiltration and 3 months later. Tests without invasive measurements were repeated 4 and 30 days after ultrafiltration. Twenty-one control patients followed the same protocol but did not have ultrafiltration. Patients who underwent ultrafiltration and increased their oxygen consumption at peak exercise (peak VO2) by > 10% at the 3-month evaluation (group A1, n = 9) were separated from those who did not (group A2, n = 8); 3 patients did not complete the follow-up. Four days after the procedure, peak VO2 had risen from 17.3 +/- 0.8 to 19.3 +/- 0.9 ml/min/kg in group A1, and from 11.9 +/- 0.7 to 14.1 +/- 0.7 ml/min/kg in group A2 (p < 0.01). Plasma norepinephrine and pulmonary function were consistent with a greater severity of the syndrome in group A2. At 3 months in group A1, the relations of filling pressure to cardiac index of the right and left ventricles were shifted upward; the esophageal pressure swing (differences between end-expiratory and end-inspiratory pressure) for a given tidal volume was lower; the peak exercise dynamic lung compliance had increased from 0.10 +/- 0.05 to 0.14 +/- 0.03 L/mm Hg (p < 0.01). None of these changes were detected in group A2 and control patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
P G Agostoni; G C Marenzi; P Sganzerla; E Assanelli; M Guazzi; G B Perego; G Lauri; E Doria; M Pepi; M D Guazzi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  76     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-11-21     Completed Date:  1995-11-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  793-8     Citation Subset:  AIM; IM    
Affiliation:
Istituto di Cardiologia, Centro Cardiologico-Fondazione Monzino, Università di Milano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Body Fluids / metabolism*
Esophagus / physiopathology
Exercise Test
Exercise Tolerance*
Follow-Up Studies
Heart / physiopathology*
Heart Failure / metabolism,  physiopathology*
Hemodynamics
Humans
Lung / physiopathology*
Lung Compliance
Middle Aged
Norepinephrine / blood
Oxygen Consumption
Pressure
Tidal Volume
Ultrafiltration
Ventricular Pressure
Chemical
Reg. No./Substance:
51-41-2/Norepinephrine

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


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