Document Detail

A characteristic change in ventilation mode during exertional dyspnea in patients with chronic heart failure.
MedLine Citation:
PMID:  7924467     Owner:  NLM     Status:  MEDLINE    
Although exertional dyspnea is an important symptom limiting daily lives in patients with chronic heart failure, there is no objective assessment of this symptom. To characterize the exertional dyspnea, ventilatory responses to exercise were studied in relation to exertional dyspnea. Gas exchange data were obtained during a maximal bicycle exercise in 43 patients with chronic heart failure and 20 normal subjects. In addition to standard ventilatory variables, the ventilation mode was assessed from the tidal volume-ventilation rate (VT-f) relationship. The exercise was performed again after sublingual administration of 5 mg of isosorbide dinitrate. In normal subjects, the f and VT increased almost proportionally with exercise intensity. In 17 (85 percent) of 20 patients with exertional dyspnea, the VT-f relationship abruptly lost linearity at the onset of exertional dyspnea. This change resulted from an inadequate increase in VT and a further increase in f. In 8 of these 17 patients, isosorbide dinitrate improved exertional dyspnea with normalization of the VT-f relationship; however, in 9 patients whose dyspnea was not improved, the abnormal VT-f relationship was unaltered. Only 2 (9 percent) of 23 patients without exertional dyspnea showed the abnormal VT-f relationship. Other ventilatory variables were not different between patients with and without dyspnea. Thus, exertional dyspnea is characterized by simultaneous appearance of rapid and shallow ventilation. The VT-f relationship appears to be a simple and useful objective assessment of exertional dyspnea in patients with chronic heart failure.
H Yokoyama; H Sato; M Hori; H Takeda; T Kamada
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  106     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-04     Completed Date:  1994-11-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1007-13     Citation Subset:  AIM; IM    
First Department of Medicine, Osaka University School of Medicine, Japan.
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MeSH Terms
Dyspnea / physiopathology*,  prevention & control
Exercise Test
Exercise Tolerance / physiology*
Heart Failure / diagnosis,  physiopathology*
Isosorbide Dinitrate / pharmacology
Middle Aged
Pulmonary Gas Exchange / physiology
Reproducibility of Results
Respiration / drug effects,  physiology
Tidal Volume / physiology
Reg. No./Substance:
87-33-2/Isosorbide Dinitrate

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

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