Document Detail


Oscillatory ventilation during exercise in patients with chronic heart failure: clinical correlates and prognostic implications.
MedLine Citation:
PMID:  12006446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: Although breathing disorders are often found in patients with chronic heart failure, exertional oscillatory ventilation (EOV) has been occasionally described. The aim of this study was to determine the prevalence, clinical characteristics, and outcome of patients with chronic heart failure and EOV. SETTING: Cardiology division at tertiary-care hospital. STUDY POPULATION: We studied 323 patients with chronic heart failure and left ventricular ejection fraction (LVEF) < or = 40%. MEASUREMENTS AND RESULTS: All patients performed a symptom-limited cardiopulmonary exercise test and were followed up for 22 +/- 11 months (mean +/- SD). EOV was defined as cyclic fluctuations in minute ventilation (E) at rest that persist during effort lasting > or = 60% of the exercise duration, with an amplitude > or = 15% of the average resting value. Patients with EOV (12%), as compared to those without, showed higher New York Heart Association (NYHA) class (p < 0.05) and lower LVEF (p < 0.0001) and peak oxygen consumption (O(2)) [p < 0.0001]. During the follow-up period, 53 patients died or underwent urgent cardiac transplantation; this group showed higher NYHA class (p < 0.05) and E/CO(2) slope (p < 0.0001) and lower LVEF (p < 0.0001), mitral Doppler early deceleration time (p < 0.01), and peak O(2) (p < 0.0001). EOV was more frequent in nonsurvivors than in survivors (28% vs 9%, p < 0.01). Multivariate analysis revealed peak O(2) (chi(2), 51.5; p < 0.0001), EOV (chi(2), 45.4; p < 0.0001), and LVEF (chi(2), 20.6; p < 0.0001) as independent predictors of major cardiac events. CONCLUSIONS: EOV is not unusual in patients with chronic heart failure, and is associated with worse clinical status, cardiac function, and exercise capacity. EOV is a powerful predictor of poor prognosis and, consequently, it may be considered a valuable guide in the management of patients with chronic heart failure and should suggest a more aggressive medical treatment policy when detected.
Authors:
Ugo Corrà; Andrea Giordano; Enzo Bosimini; Alessandro Mezzani; Massimo Piepoli; Andrew J S Coats; Pantaleo Giannuzzi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  121     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-13     Completed Date:  2002-06-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1572-80     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Veruno, Italy. ucorra@fsm.it
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MeSH Terms
Descriptor/Qualifier:
Cheyne-Stokes Respiration / diagnosis*,  etiology
Echocardiography
Exercise Test*
Female
Heart Failure / complications,  mortality,  physiopathology*,  ultrasonography
Humans
Male
Middle Aged
Prognosis
Pulmonary Ventilation
Reproducibility of Results
Stroke Volume
Survival Rate

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


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