Ventilatory mechanisms of exercise intolerance in chronic heart failure
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2020, Heart Failure ClinicsDietary nitrate supplementation opposes the elevated diaphragm blood flow in chronic heart failure during submaximal exercise
2018, Respiratory Physiology and NeurobiologyCitation Excerpt :Furthermore, CHF is associated with respiratory muscle weakness (Dall’Ago et al., 2006) and pulmonary abnormalities such as increased physiological dead space, mild ventilation/perfusion mismatch, lower lung diffusion capacity, and obstructive-restrictive lung disorders (Poole et al., 2012). These pulmonary abnormalities result in a greater cost and work of breathing for a given rate of ventilation (Cross et al., 2012), which in concert with the exaggerated ventilatory response in CHF patients compared to healthy individuals (Sullivan et al., 1988; Agostoni et al., 2010; Myers et al., 1992) conflate to elevate diaphragm BF during submaximal exercise (Musch, 1993; Smith et al., 2017d). Furthermore, the elevated work of breathing in CHF results in the redistribution of cardiac output from the locomotor to the respiratory muscles during submaximal exercise further reducing locomotor O2 delivery and exercise tolerance (Miller et al., 2007; Olson et al., 2010; Musch, 1993; Smith et al., 2017d).
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