| Ultrafiltration in moderate heart failure. Exercise oxygen uptake as a predictor of the clinical benefits. | |
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MedLine Citation:
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PMID: 7607000 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Ultrafiltration (UF) can improve the exercise performance of patients with moderate congestive heart failure (CHF). Our aim was to define the starting levels of performance below which UF is beneficial. PATIENTS AND METHOD: We studied 26 patients in 2 to 3 NYHA class, whose clinical condition was stable, left ventricle ejection fraction (echocardiography) was < 35% and peak exercise oxygen uptake (VO2) was > or = 14 mL/min/kg. They underwent a single extracorporeal UF (about 600 mL of ultrafiltrate per hour). Before that, we evaluated pulmonary function (PFT), functional capacity (cardiopulmonary exercise test [CPX]), cardiac index, left ventricle ejection fraction, ventricular filling pressures, and plasma norepinephrine at rest. The PFTs and CPXs were repeated 3 months after UF. RESULTS: Sixteen patients had a rise of peak exercise VO2 > 1 mL/min/kg at the 3-month evaluation (group A, ultrafiltrate = 2,040 +/- 241 mL) and 10 did not (group B, ultrafiltrate = 1,870 +/- 169 mL). Forced expiratory volume (1 s), maximal voluntary ventilation, and vital capacity were lower in group A than in group B and improved after UF only in group A. Before UF, VO2 at peak exercise and at anaerobic threshold (15.5 +/- 0.4 mL/min/kg and 11.0 +/- 0.5, respectively) was also lower in group A than in group B (21.2 +/- 0.7 mL/min/kg and 14.8 +/- 0.9, p < 0.01). Patients whose pre-UF peak exercise VO2 was > 18.5 mL/min/kg (group B) had no increase in this variable. No significant group differences were detected regarding norepinephrine, left ventricular ejection fraction, and hemodyanmic parameters at rest. CONCLUSION: In patients with moderate CHF undergoing UF, exercise capacity improvement is inversely related to the pre-UF level of physical performance and pulmonary function; VO2 at peak exercise seems useful for identification of patients not benefiting from the procedure. |
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Authors:
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G C Marenzi; G Lauri; M Guazzi; G B Perego; P G Agostoni |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chest Volume: 108 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 1995 Jul |
Date Detail:
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Created Date: 1995-08-17 Completed Date: 1995-08-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 94-8 Citation Subset: AIM; IM |
Affiliation:
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Istituto di Cardiologia, Università degli Studi, Centro Cardilogico-Fondazione I Monzino, IRCCS, Centro di Studio pe le Ricerche Cardiovascular del CNR, Milan, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Exercise Test Forced Expiratory Volume Heart Failure / physiopathology*, therapy* Hemodynamics Hemofiltration* Humans Middle Aged Oxygen Consumption* Stroke Volume Treatment Outcome Vital Capacity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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