Chest
Clinical Investigations: CardiologyA Characteristic Change in Ventilation Mode During Exertional Dyspnea in Patients With Chronic Heart Failure
Section snippets
Subjects
We studied 43 ambulatory patients with left ventricular dysfunction and symptoms of mild-to-moderate heart failure, ie, fatigue or dyspnea on effort, as a heart failure group (Table 1). There were 37 men and 6 women, ranging in age from 22 to 79 years (53±2 years, mean±SEM). Thirty patients were classified in New York Heart Association functional class II and 13 were in class III. The cause of heart failure was dilated cardiomyopathy in 27 patients, ischemic cardiomyopathy without angina
Subjective Complaint of Exertional Dyspnea
Among 43 patients in the heart failure group, 20 patients complained of exertional dyspnea at a submaximal exercise level, although they could continue exercise until exhaustion. Exertional dyspnea developed rather abruptly and hence, its onset could be identified in these patients. According to the presence or absence of exertional dyspnea, the heart failure group was divided into two subgroups: group A consisted of 20 patients with exertional dyspnea, and group B included the remaining 23
Discussion
The present study demonstrates that exertional dyspnea in patients with chronic heart failure is characterized by a simultaneous change in the ventilation mode as reflected by an abrupt change in the Vt-f relationship indicating the appearance of rapid and shallow ventilation. Standard gas exchange measurements, including ventilatory equivalent for carbon dioxide, were unable to provide an objective measure of exertional dyspnea. Several investigators have already demonstrated rapid and shallow
ACKNOWLEDGMENT
We are grateful to Dr. Michitoshi Inoue, professor of the Faculty of Medical Information Science of Osaka University School of Medicine, for his helpful comments and criticisms in preparing this manuscript.
References (28)
- et al.
Exercise ventilation and pulmonary artery wedge pressure in chronic stable congestive heart failure
Am J Cardiol
(1986) - et al.
Contrasting cardiovascular and respiratory responses to exercise in mitral valve and chronic obstructive pulmonary diseases
Chest
(1983) - et al.
Relation between hemodynamic and ventilatory responses in determining exercise capacity in severe congestive heart failure
Am J Cardiol
(1984) - et al.
Respiratory muscle deoxygenation during exercise in patients with heart failure demonstrated with near-infrared spectroscopy
J Am Coll Cardiol
(1991) - et al.
Isosorbide dinitrate for the relief of severe heart failure after myocardial infarction
Am J Cardiol
(1976) - et al.
Exercise intolerance in patients with chronic heart failure: role of impaired nutritive flow to skeletal muscle
Circulation
(1984) - et al.
Blood flow distribution within skeletal muscle during exercise in the presence of chronic heart failure: effect of milrinone
Circulation
(1987) - et al.
Relation between central and peripheral hemodynamics during exercise in patients with chronic heart failure
Circulation
(1989) - et al.
Contribution of intrinsic skeletal muscle changes to 31P NMR skeletal muscle metabolic abnormalities in patients with chronic heart failure
Circulation
(1989) - et al.
Skeletal muscle biochemistry and histology in ambulatory patients with long-term heart failure
Circulation
(1990)
Alterations of skeletal muscle in chronic heart failure
Circulation
Ventilation and gas exchange during exercise in severe chronic heart failure
Am Rev Respir Dis
Increased exercise ventilation in patients with chronic heart failure: intact ventilatory control despite hemodynamic and pulmonary abnormalities
Circulation
Heart disease
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2020, Journal of CardiologyCitation Excerpt :Further studies are needed to completely understand this mechanism. Yokoyama et al. reported a low TV-RR slope value at early exercise phase; it may be a useful parameter for exertional dyspnea with no difference in the VE/VCO2 ratio [8] diagnosis. Interestingly, we showed S1 as being lower but with significant correlation in %peak VO2.
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This study was presented in part in the 62nd Scientific Session of the American Heart Association.