Document Detail

Respiratory control during exercise in patients with cardiovascular disease.
MedLine Citation:
PMID:  8430969     Owner:  NLM     Status:  MEDLINE    
The pathophysiologic mechanism for exertional dyspnea, the main symptom of patients with heart failure, has not been fully clarified. To determine the relationship between exercise hyperpnea and the lactic acidosis in patients with heart failure, we evaluated ventilation during incremental exercise both below and above the lactic acidosis threshold in 16 normal subjects and in 48 patients with cardiovascular disease while expired gas was analyzed continuously. The peak oxygen uptake and oxygen uptake at the lactic acidosis threshold decreased significantly as the New York Heart Association (NYHA) functional class severity increased. the slope of the increase in ventilation to the increase in oxygen uptake (delta VE/delta VO2) at work rates below the lactic acidosis threshold did not differ between normal subjects and patients with heart failure. Above the lactic acidosis threshold, however, the slope of delta VE/delta VO2, which was higher than that below the lactic acidosis threshold in each of four groups, was steeper in patients in NYHA Class II (60.8 +/- 17.9) and Class III (66.5 +/- 21.2) when compared with that in the normal subjects (46.6 +/- 13.5) or the patients in NYHA Class I (46.1 +/- 10.3). The lactic acidosis caused by decreased oxygen transport to working muscles accounts for the higher ventilation during exercise in cardiac patients. These data suggest that the increased ventilation during exercise, which must be related to exertional dyspnea, in patients with cardiovascular disease is primarily the consequence of a stimulus to regulate arterial pH.
A Koike; M Hiroe; K Taniguchi; F Marumo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  147     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1993 Feb 
Date Detail:
Created Date:  1993-03-09     Completed Date:  1993-03-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  425-9     Citation Subset:  AIM; IM; S    
Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
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MeSH Terms
Acidosis, Lactic / epidemiology,  physiopathology
Analysis of Variance
Breath Tests
Cardiovascular Diseases / epidemiology,  physiopathology*
Exercise / physiology*
Exercise Test / instrumentation,  methods,  statistics & numerical data
Middle Aged
Oxygen Consumption / physiology
Respiration / physiology*
Respiratory Mechanics / physiology
Comment In:
Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):1146-7   [PMID:  8214935 ]

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

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