Author |
Rocha, Alcides
![]() ![]() Arbex, Flavio Ferlin ![]() ![]() Alencar, Maria Clara Noman de ![]() ![]() Sperandio, Priscila Abreu ![]() ![]() Hirai, Daniel Müller ![]() ![]() Berton, Danilo C. ![]() O'Donnell, Denis E. ![]() Neder, Jose Alberto ![]() ![]() |
Abstract | Background: Exercise oscillatory ventilation (EOV) is associatedwith poor ventilatory efficiency and higher operating lung volumes in heart failure. These abnormalitiesmay be particularly deleterious to dyspnea and exercise tolerance in mechanically-limited patients, e.g. those with coexistent COPD. Methods: Ventilatory, gas exchange and sensory responses to incremental exercise were contrasted in 68 heart failure-COPD patients (12 EOV+). EOV was established by standard criteria. Results: Compared to EOV-, EOV+ had lower exercise capacity, worse ventilatory inefficiency and higher peak dyspnea scores (p < 0.05). Peak capillary PCO2 (PcCO2) was higher and end-tidal CO2 (PETCO2) was lower in EOV+. Thus, greater (i.e., more positive) P(c-ET) CO2 and dead space/tidal volume values were found in these patients compared to EOV- (p < 0.05). Ventilatory inefficiency was related to increased dead space/tidal volumein EOV+ (r = 0.74 p < 0.01). Owing to higher operating lung volumes, inspiratory reserve volume (IRV) decreased to a greater extent in EOV+. Tidal volume oscillations consistently ceased when a "critical" IRV was reached (similar to 0.3-0.5 L) thereafter, PcCO2 stabilized or increased and dyspnea scores rose sharply. Exercise capacity was closely related to IRV decrements and peak dyspnea in EOV+ (r = -0.78 and 0.84, respectively p < 0.01). Conclusions: Dyspnea and exercise tolerance are negatively influenced by EOV in heart failure patients presenting with COPD as co-morbidity. Pharmacological and non-pharmacological interventions known to decrease EOV might prove particularly valuable to mitigate symptomburden and exercise intolerance in this specific heart failure group. (C) 2016 Elsevier Ireland Ltd. All rights reserved. |
Keywords |
Heart failure
COPD Exertion Ventilation Lung mechanics Dyspnea |
xmlui.dri2xhtml.METS-1.0.item-coverage | Clare |
Language | English |
Date | 2016 |
Published in | International Journal Of Cardiology. Clare, v. 224, p. 447-453, 2016. |
ISSN | 0167-5273 (Sherpa/Romeo, impact factor) |
Publisher | Elsevier Ireland Ltd |
Extent | 447-453 |
Origin |
|
Access rights | Closed access |
Type | Article |
Web of Science ID | WOS:000390471300081 |
URI | https://repositorio.unifesp.br/handle/11600/56623 |
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