Document Detail


Is ventilatory efficiency (VE/VCO(2) slope) associated with right ventricular oxidative metabolism in patients with congestive heart failure?
MedLine Citation:
PMID:  18818123     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The relationship between minute ventilation and the rate of CO2 elimination (VE/VCO2 slope) is associated with mortality in patients with congestive heart failure (CHF). The VE/VCO2 slope > or =34 denotes a poor prognosis and has been proposed to reflect abnormalities in pulmonary perfusion.
AIMS: To study whether increased VE/VCO2 slope is associated with elevated right ventricular (RV) oxidative metabolism relative to the left ventricle (LV).
METHODS: 21 patients with stable NYHA II-III CHF underwent symptom limited cardiopulmonary exercise testing. Dynamic [(11)C]acetate positron emission tomography (PET) was used to measure oxidative metabolism (k(mono)) of the LV and RV. Corrected RV oxidative metabolism (RVOx) was calculated as RV/LV k(mono) ratio.
RESULTS: Peak VO2 was 16.2+/-4.1 ml/min/kg and the VE/VCO2 slope was 33.4+/-6.1. LV and RV k(mono) were 0.046+/-0.009 and 0.037+/-0.007 min(-1), respectively, with a RVOx of 0.83+/-0.17. There was a good correlation between RVOx and the VE/VCO2 slope (r=0.61, p=0.0034). RVOx was 0.77+/-0.16 in patients with a VE/VCO2 slope <34 and 0.93+/-0.16 in patients with VE/VCO2 slope > or =34 (p=0.047).
CONCLUSION: RVOx correlates with VE/VCO2 slope in CHF patients. This supports the hypothesis that pulmonary vascular resistance is a determinant of the VE/VCO2 slope.
Authors:
Heikki Ukkonen; Ian G Burwash; William Dafoe; Robert A de Kemp; Haissam Haddad; Keiichiro Yoshinaga; Ross A Davies; Edward K Gannon; Jean N Dasilva; Rob S B Beanlands
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-09-24
Journal Detail:
Title:  European journal of heart failure     Volume:  10     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-23     Completed Date:  2009-02-03     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:  1117-22     Citation Subset:  IM    
Affiliation:
Department of Medicine, Turku University Hospital, Turku, Finland. heikki.ukkonen@tyks.fi
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MeSH Terms
Descriptor/Qualifier:
Disease Progression
Exercise Test
Exercise Tolerance / physiology
Female
Heart Failure / metabolism*,  physiopathology,  radionuclide imaging
Heart Ventricles / metabolism*,  physiopathology,  radionuclide imaging
Humans
Male
Middle Aged
Oxygen Consumption / physiology*
Prognosis
Pulmonary Gas Exchange
Pulmonary Ventilation / physiology*
Spirometry
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left / physiology*

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


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