Causes of breathing inefficiency during exercise in heart failure

Research output: Contribution to journalArticle

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Abstract

Background: Patients with heart failure (HF) develop abnormal pulmonary gas exchange; specifically, they have abnormal ventilation relative to metabolic demand (ventilatory efficiency/minute ventilation in relation to carbon dioxide production [VE/VCO2]) during exercise. The purpose of this investigation was to examine the factors that underlie the abnormal breathing efficiency in this population. Methods and Results: Fourteen controls and 33 moderate-severe HF patients, ages 52 ± 12 and 54 ± 8 years, respectively, performed submaximal exercise (∼65% of maximum) on a cycle ergometer. Gas exchange and blood gas measurements were made at rest and during exercise. Submaximal exercise data were used to quantify the influence of hyperventilation (PaCO2) and dead space ventilation (VD) on VE/VCO2. The VE/VCO2 relationship was lower in controls (30 ± 4) than HF (45 ± 9, P < .01). This was the result of hyperventilation (lower PaCO2) and higher V D/VT that contributed 40% and 47%, respectively, to the increased VE/VCO2 (P < .01). The elevated V D/VT in the HF patients was the result of a tachypneic breathing pattern (lower VT, 1086 ± 366 versus 2003 ± 504 mL, P < .01) in the presence of a normal VD (11.5 ± 4.0 versus 11.9 ± 5.7 L/min, P = .095). Conclusions: The abnormal ventilation in relation to metabolic demand in HF patients during exercise was due primarily to alterations in breathing pattern (reduced VT) and excessive hyperventilation.

Original languageEnglish (US)
Pages (from-to)835-842
Number of pages8
JournalJournal of Cardiac Failure
Volume16
Issue number10
DOIs
StatePublished - Oct 2010

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Respiration
Heart Failure
Ventilation
Hyperventilation
Exercise
Gases
Pulmonary Gas Exchange
Carbon Dioxide
Population

Keywords

  • arterial CO
  • dead space ventilation
  • V/VCO

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Causes of breathing inefficiency during exercise in heart failure. / Woods, Paul R.; Olson, Thomas P; Frantz, Robert; Johnson, Bruce David.

In: Journal of Cardiac Failure, Vol. 16, No. 10, 10.2010, p. 835-842.

Research output: Contribution to journalArticle

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abstract = "Background: Patients with heart failure (HF) develop abnormal pulmonary gas exchange; specifically, they have abnormal ventilation relative to metabolic demand (ventilatory efficiency/minute ventilation in relation to carbon dioxide production [VE/VCO2]) during exercise. The purpose of this investigation was to examine the factors that underlie the abnormal breathing efficiency in this population. Methods and Results: Fourteen controls and 33 moderate-severe HF patients, ages 52 ± 12 and 54 ± 8 years, respectively, performed submaximal exercise (∼65{\%} of maximum) on a cycle ergometer. Gas exchange and blood gas measurements were made at rest and during exercise. Submaximal exercise data were used to quantify the influence of hyperventilation (PaCO2) and dead space ventilation (VD) on VE/VCO2. The VE/VCO2 relationship was lower in controls (30 ± 4) than HF (45 ± 9, P < .01). This was the result of hyperventilation (lower PaCO2) and higher V D/VT that contributed 40{\%} and 47{\%}, respectively, to the increased VE/VCO2 (P < .01). The elevated V D/VT in the HF patients was the result of a tachypneic breathing pattern (lower VT, 1086 ± 366 versus 2003 ± 504 mL, P < .01) in the presence of a normal VD (11.5 ± 4.0 versus 11.9 ± 5.7 L/min, P = .095). Conclusions: The abnormal ventilation in relation to metabolic demand in HF patients during exercise was due primarily to alterations in breathing pattern (reduced VT) and excessive hyperventilation.",
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