| VE/VCO2 slope is associated with abnormal resting haemodynamics and is a predictor of long-term survival in chronic heart failure. | |
| | |
MedLine Citation:
|
PMID: 16310408 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Patients with chronic heart failure (CHF) present with exercise-induced hyperpnea, but its pathophysiological mechanism has not been thoroughly investigated. We aimed to determine the relationship between exercise-induced hyperpnea, resting haemodynamic measurements and the validity of ventilatory response (V(E)/V(CO(2)) slope) as a mortality predictor in CHF patients. METHODS: Ninety-eight CHF patients (90M/8F) underwent a symptom-limited treadmill cardiopulmonary exercise test (CPET). Right heart catheterization and radionuclide ventriculography were performed within 72 h of CPET. RESULTS: Twenty-seven patients died from cardiac causes during 20+/-6 months follow-up. Non-survivors had a lower peak oxygen consumption (V(O(2)p)), (16.5+/-4.9 vs. 20.2+/-6.1, ml/kg/min, p=0.003), a steeper V(E)/V(CO(2)) slope (34.8+/-8.3 vs. 28.9+/-4.8, p<0.001) and a higher pulmonary capillary wedge pressure (PCWP) (19.5+/-8.6 vs. 11.7+/-6.5 mm Hg, p=0.008) than survivors. By multivariate survival analysis, the V(E)/V(CO(2)) slope as a continuous variable was an independent prognostic factor (chi(2): 8.5, relative risk: 1.1, 95% CI: 1.03-1.18, p=0.004). Overall mortality was 52% in patients with V(E)/V(CO(2)) slope > or =34 and 18% in those with V(E)/V(CO(2)) slope <34 (log rank: 18.5, p<0.001). In a subgroup of patients (V(O(2)p): 10-18 ml/kg/min), V(E)/V(CO(2)) slope was a significant predictor of mortality (relative risk: 6.2, 95% CI: 1.7-22.2, p=0.002). Patients with high V(E)/V(CO(2)) slope had higher resting PCWP (19.9+/-9.1 vs. 11.3+/-5.7 mmHg, p<0.001) and V(E)/V(CO(2)) slope correlated significantly with PCWP (r: 0.57, p<0.001). CONCLUSIONS: The V(E)/V(CO(2)) slope, as an index of ventilatory response to exercise, improves the risk stratification of CHF patients. Interstitial pulmonary oedema may be a pathophysiological mechanism of inefficient ventilation during exercise in these patients. |
| | |
Authors:
|
Serafim N Nanas; John N Nanas; Dimitrios Ch Sakellariou; Stavros K Dimopoulos; Stavros G Drakos; Smaragdo G Kapsimalakou; Christina A Mpatziou; Ourania G Papazachou; Anargyros S Dalianis; Maria I Anastasiou-Nana; Charis Roussos |
Related Documents
:
|
11150968 - Normal skeletal muscle na(+)-k(+) pump concentration in patients with chronic heart fai... 2125668 - The role of oxygen extraction in peripheral tissues in exercise capacity in chronic hea... 10424508 - Effects of aerobic exercise training on indices of ventricular repolarization in patien... 947578 - Impaired forearm oxygen consumption during static exercise in patients with congestive ... 6653688 - Radiographic evaluation of regional pulmonary dimensions and volumes: effect of age. 7994808 - Fibrin formation and degradation in patients with arteriosclerotic disease. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2005-11-28 |
Journal Detail:
|
Title: European journal of heart failure Volume: 8 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2006 Jun |
Date Detail:
|
Created Date: 2006-06-12 Completed Date: 2006-11-01 Revised Date: 2011-06-08 |
Medline Journal Info:
|
Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 420-7 Citation Subset: IM |
Affiliation:
|
Pulmonary and Critical Care Medicine Department, Cardiopulmonary Exercise Testing And Rehabilitation Laboratory, Evgenidio Hospital, National and Kapodestrian University of Athens, Greece. snanas@cc.uoa.gr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Carbon Dioxide / analysis* Cardiac Output, Low / physiopathology* Exercise Test Female Hemodynamics* Humans Male Middle Aged Oxygen Consumption Prognosis Survival Analysis* |
| Chemical | |
Reg. No./Substance:
|
124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Vasoactive intestinal peptide--release from the heart and response in heart failure due to left vent...
Next Document: The neurophysiology of the alternating leg muscle activation (ALMA) during sleep: study of one patie...