| The role of right and left ventricular function in the ventilatory response to exercise in chronic heart failure. | |
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MedLine Citation:
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PMID: 8181130 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Right ventricular function may be an important determinant of exercise capacity, peak oxygen consumption (VO2), and the ventilatory response to carbon dioxide production (VE/VCO2 relation) in patients with chronic heart failure (CHF). METHODS AND RESULTS: We studied the role of right ventricular function in CHF and also investigated the effects of absent right ventricular reserve in patients previously operated on with Fontan's procedure by measuring metabolic gas exchange during exercise in five groups of patients: (1) 10 patients who had previously undergone Fontan's procedure for congenital heart disease in whom the right ventricle is not functional; (2) 11 age-matched control subjects with dilated cardiomyopathy (DCM); (3) 15 age-matched normal subjects; (4) 42 patients with CHF; and (5) 16 age-matched control subjects. Left and right ventricular ejection fractions (LVEF and RVEF) were measured by radionuclide ventriculography in group 4. In the young subjects, the VE/VCO2 slope was lower in the control subjects than in the other two groups, being 24.4 +/- 4.3 against 33.3 +/- 6.6 in group 1 (P < .001) and 29.6 +/- 8.1 in group 2 (P < .05). The correlation between peak VO2 and VE/VCO2 was -0.80 (P = .005) in group 1 and -0.76 (P = .007) in group 2. In the older age groups, the VE/VCO2 slope was significantly greater (38.0 +/- 14.9 versus 25.4 +/- 3.7; P < .001) in the heart failure group (group 4). In neither control group was there a significant relation between peak VO2 and VE/VCO2 slope. In group 4, the relation between peak VO2 and VE/VCO2 was similar to that seen for groups 1 and 2. LVEF was 24.3 +/- 14.1%, and RVEF was 32.5 +/- 13.1%. There was no correlation between either RVEF or LVEF and peak VO2 or VE/VCO2 slope in the heart failure group. CONCLUSIONS: The relation between excessive ventilation and reduction in peak oxygen consumption is present in patients with no functioning right ventricle. RVEF is not a determining feature of either exercise capacity or the excessive ventilatory response in CHF. |
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Authors:
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A L Clark; J W Swan; R Laney; M Connelly; J Somerville; A J Coats |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 89 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1994 May |
Date Detail:
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Created Date: 1994-06-14 Completed Date: 1994-06-14 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2062-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Medicine, National Heart and Lung Institute, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiomyopathy, Dilated / physiopathology Exercise Test Exercise Tolerance / physiology* Heart Defects, Congenital / physiopathology Heart Failure / physiopathology* Humans Middle Aged Pulmonary Gas Exchange / physiology* Radionuclide Ventriculography Stroke Volume / physiology Tricuspid Valve / abnormalities Ventricular Function, Left / physiology* Ventricular Function, Right / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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