Exercise hyperventilation chronic congestive heart failure, and its relation to functional capacity and hemodynamics

https://doi.org/10.1016/0002-9149(92)90202-AGet rights and content

Abstract

The ventilatory response to exercise was evaluated in 26 normal sedentary men and 68 patients with chronic heart failure using the slope of the relation between minute ventilation (VE) and carbon dioxide production (VCO2). All subjects underwent maximal upright bicycle cardiopulmonary exercise testing; 33 patients also underwent right-sided cardiac catheterization. The slope of VEVCO2 was calculated by linear regression analysis using data from all the exercise tests and the first 60% of exercise duration; a high correlation was seen between these results (r = 0.83; p <0.001). The slope of VEVCO2was significantly, though weakly, related to peak exercise work load, oxygen consumption and ventilatory threshold (r = −0.49, −0.56 and −0.49, respectively), several peak exercise hemodynamic parameters and peak exercise dead space/tidal volume ratio (r = 0.70). With use of multivariate analysis, the only independent determinants of the slope were peak exercise dead space/tidal volume ratio and cardiac index. Thus, in patients with heart failure, exercise hyperventilation can contribute to the impairment of functional capacity and can be considered a compensatory response to abnormal hemodynamics and lung blood distribution in order to keep blood gas concentrations normal.

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    This study was supported by the target project FATMA of the National Council of Research, Rome, Italy.

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