Document Detail

Relation between oscillatory ventilation at rest before cardiopulmonary exercise testing and prognosis in patients with left ventricular dysfunction.
MedLine Citation:
PMID:  12576354     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although nocturnal Cheyne-Stokes respiration alternating between hyperpnea and hypopnea has been considered a sign of severe heart failure, the clinical status of cardiac patients who exhibit oscillatory ventilation during wakefulness has not been clarified. This study was carried out to determine the relation between oscillatory ventilation during wakefulness and exercise capacity in patients with chronic heart disease. We also evaluated retrospectively whether the presence of oscillatory ventilation influences the long-term prognosis in these patients. METHODS: A total of 164 patients with left ventricular dysfunction performed a symptom-limited incremental exercise test. Respiratory gas exchange was measured on a breath-by-breath basis throughout the test. Oscillatory ventilation was defined when clear ventilatory oscillation of at least two consecutive cycles was identified at rest before exercise testing and the difference between the peak and nadir of oscillating ventilation was > 30% of the mean value of ventilation. RESULTS: Oscillatory ventilation was noted in 45 of 164 cardiac patients (27%), and the magnitude (mean +/- SD) of oscillation in these patients was 45.5 +/- 16.9%. Patients with oscillatory ventilation had significantly lower left ventricular ejection fraction than those without it (40.7 +/- 12.7% vs 44.9 +/- 11.6%, p < 0.05). However, parameters of exercise capacity such as the peak oxygen uptake (O(2)), the slope of the increase in O(2) relative to the increase in work rate (DeltaO(2)/DeltaWR), and the ratio of the increase in ventilation to the increase in carbon dioxide output (DeltaE/DeltaCO(2)) were not significantly different between the two groups. The mortality rate during 1,797 +/- 599 days of follow-up did not differ between the groups (p = 0.65). CONCLUSIONS: Oscillatory ventilation present at rest before cardiopulmonary exercise testing is not significantly related to the peak O(2), DeltaO(2)/DeltaWR, DeltaE/DeltaCO(2), or prognosis in patients with left ventricular dysfunction.
Akira Koike; Noritaka Shimizu; Akihiko Tajima; Tadanori Aizawa; Long Tai Fu; Hiroshi Watanabe; Haruki Itoh
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  123     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-10     Completed Date:  2003-02-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-9     Citation Subset:  AIM; IM    
Cardiovascular Institute, Tokyo, Japan.
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MeSH Terms
Cheyne-Stokes Respiration / diagnosis*,  mortality,  physiopathology
Coronary Disease / diagnosis,  mortality,  physiopathology
Exercise Test*
Follow-Up Studies
Middle Aged
Myocardial Infarction / diagnosis,  mortality,  physiopathology
Retrospective Studies
Stroke Volume / physiology
Survival Rate
Ventricular Dysfunction, Left / diagnosis*,  mortality,  physiopathology

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