Influence of cardiomegaly on disordered breathing during exercise in chronic heart failure

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Abstract

AimsHeart failure (HF) patients breathe with a rapid shallow pattern during exercise. This study examined the relationship between cardiac size and tachypnoeic breathing in HF patients during exercise.Methods and resultsThirty-seven HF patients [age 55 ± 13 years, ejection fraction (EF) 27 ± 10, New York Heart Association (NYHA) class 2.3 ± 1.2] and 42 controls (CTL) (age 56 ± 14 years, EF 63 ± 8) were recruited. Participants underwent maximal exercise testing, pulmonary function testing, and chest radiography for calculation of total thoracic cavity volume (TTCV), diaphragm, heart, and lung volumes. Heart failure patients were divided into two groups: Group A cardiac volume < median (n 18) and Group B cardiac volume < median of the HF patients (n 19). There was no difference between groups for TTCV (CTL 8203 ± 1489 vs. Group A 8694 ± 1249 vs. Group B 8195 ± 1823 cm 3). Cardiac volume was different between groups for both absolute (CTL 630 ± 181 vs. Group A 894 ± 186 vs. Group B 1401 ± 382 cm 3, P< 0.001 for all comparisons) and TTCV (CTL 8 ± 2 vs. Group A 10 ± 1 vs. Group A 18 ± 5, P< 0.001 for all comparisons). Similarly, total lung volume as a TTCV was significantly different among the groups (CTL 70 ± 4 vs. Group A 65 ± 5 vs. Group A 58 ± 7, P< 0.01 for all comparisons). In HF patients, there was a trend (P 0.10) towards an independent association between cardiac size and tidal volume (VT) at 75 of VO 2 peak whereas this relationship was statistically significant at VO 2 peak (P= 0.02) as patients with larger cardiac size had reduced VT.ConclusionThis study demonstrates the close relationship between cardiac size and breathing pattern during exercise in HF patients. These results suggest cardiac size may pose a significant constraint on the lungs during exercise and may contribute to tachypnoeic breathing.

Original languageEnglish (US)
Pages (from-to)311-318
Number of pages8
JournalEuropean Journal of Heart Failure
Volume13
Issue number3
DOIs
StatePublished - Mar 2011

Fingerprint

Breathing Exercises
Cardiomegaly
Cardiac Volume
Heart Failure
Thoracic Cavity
Exercise
Lung
Respiration
antineoplaston A10
Tidal Volume
Diaphragm
Radiography
Thorax
Control Groups

Keywords

  • Heart size
  • Tachypnoea
  • Ventilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Influence of cardiomegaly on disordered breathing during exercise in chronic heart failure",
abstract = "AimsHeart failure (HF) patients breathe with a rapid shallow pattern during exercise. This study examined the relationship between cardiac size and tachypnoeic breathing in HF patients during exercise.Methods and resultsThirty-seven HF patients [age 55 ± 13 years, ejection fraction (EF) 27 ± 10, New York Heart Association (NYHA) class 2.3 ± 1.2] and 42 controls (CTL) (age 56 ± 14 years, EF 63 ± 8) were recruited. Participants underwent maximal exercise testing, pulmonary function testing, and chest radiography for calculation of total thoracic cavity volume (TTCV), diaphragm, heart, and lung volumes. Heart failure patients were divided into two groups: Group A cardiac volume < median (n 18) and Group B cardiac volume < median of the HF patients (n 19). There was no difference between groups for TTCV (CTL 8203 ± 1489 vs. Group A 8694 ± 1249 vs. Group B 8195 ± 1823 cm 3). Cardiac volume was different between groups for both absolute (CTL 630 ± 181 vs. Group A 894 ± 186 vs. Group B 1401 ± 382 cm 3, P< 0.001 for all comparisons) and TTCV (CTL 8 ± 2 vs. Group A 10 ± 1 vs. Group A 18 ± 5, P< 0.001 for all comparisons). Similarly, total lung volume as a TTCV was significantly different among the groups (CTL 70 ± 4 vs. Group A 65 ± 5 vs. Group A 58 ± 7, P< 0.01 for all comparisons). In HF patients, there was a trend (P 0.10) towards an independent association between cardiac size and tidal volume (VT) at 75 of VO 2 peak whereas this relationship was statistically significant at VO 2 peak (P= 0.02) as patients with larger cardiac size had reduced VT.ConclusionThis study demonstrates the close relationship between cardiac size and breathing pattern during exercise in HF patients. These results suggest cardiac size may pose a significant constraint on the lungs during exercise and may contribute to tachypnoeic breathing.",
keywords = "Heart size, Tachypnoea, Ventilation",
author = "Olson, {Thomas P} and Johnson, {Bruce David}",
year = "2011",
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doi = "10.1093/eurjhf/hfq177",
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AU - Johnson, Bruce David

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N2 - AimsHeart failure (HF) patients breathe with a rapid shallow pattern during exercise. This study examined the relationship between cardiac size and tachypnoeic breathing in HF patients during exercise.Methods and resultsThirty-seven HF patients [age 55 ± 13 years, ejection fraction (EF) 27 ± 10, New York Heart Association (NYHA) class 2.3 ± 1.2] and 42 controls (CTL) (age 56 ± 14 years, EF 63 ± 8) were recruited. Participants underwent maximal exercise testing, pulmonary function testing, and chest radiography for calculation of total thoracic cavity volume (TTCV), diaphragm, heart, and lung volumes. Heart failure patients were divided into two groups: Group A cardiac volume < median (n 18) and Group B cardiac volume < median of the HF patients (n 19). There was no difference between groups for TTCV (CTL 8203 ± 1489 vs. Group A 8694 ± 1249 vs. Group B 8195 ± 1823 cm 3). Cardiac volume was different between groups for both absolute (CTL 630 ± 181 vs. Group A 894 ± 186 vs. Group B 1401 ± 382 cm 3, P< 0.001 for all comparisons) and TTCV (CTL 8 ± 2 vs. Group A 10 ± 1 vs. Group A 18 ± 5, P< 0.001 for all comparisons). Similarly, total lung volume as a TTCV was significantly different among the groups (CTL 70 ± 4 vs. Group A 65 ± 5 vs. Group A 58 ± 7, P< 0.01 for all comparisons). In HF patients, there was a trend (P 0.10) towards an independent association between cardiac size and tidal volume (VT) at 75 of VO 2 peak whereas this relationship was statistically significant at VO 2 peak (P= 0.02) as patients with larger cardiac size had reduced VT.ConclusionThis study demonstrates the close relationship between cardiac size and breathing pattern during exercise in HF patients. These results suggest cardiac size may pose a significant constraint on the lungs during exercise and may contribute to tachypnoeic breathing.

AB - AimsHeart failure (HF) patients breathe with a rapid shallow pattern during exercise. This study examined the relationship between cardiac size and tachypnoeic breathing in HF patients during exercise.Methods and resultsThirty-seven HF patients [age 55 ± 13 years, ejection fraction (EF) 27 ± 10, New York Heart Association (NYHA) class 2.3 ± 1.2] and 42 controls (CTL) (age 56 ± 14 years, EF 63 ± 8) were recruited. Participants underwent maximal exercise testing, pulmonary function testing, and chest radiography for calculation of total thoracic cavity volume (TTCV), diaphragm, heart, and lung volumes. Heart failure patients were divided into two groups: Group A cardiac volume < median (n 18) and Group B cardiac volume < median of the HF patients (n 19). There was no difference between groups for TTCV (CTL 8203 ± 1489 vs. Group A 8694 ± 1249 vs. Group B 8195 ± 1823 cm 3). Cardiac volume was different between groups for both absolute (CTL 630 ± 181 vs. Group A 894 ± 186 vs. Group B 1401 ± 382 cm 3, P< 0.001 for all comparisons) and TTCV (CTL 8 ± 2 vs. Group A 10 ± 1 vs. Group A 18 ± 5, P< 0.001 for all comparisons). Similarly, total lung volume as a TTCV was significantly different among the groups (CTL 70 ± 4 vs. Group A 65 ± 5 vs. Group A 58 ± 7, P< 0.01 for all comparisons). In HF patients, there was a trend (P 0.10) towards an independent association between cardiac size and tidal volume (VT) at 75 of VO 2 peak whereas this relationship was statistically significant at VO 2 peak (P= 0.02) as patients with larger cardiac size had reduced VT.ConclusionThis study demonstrates the close relationship between cardiac size and breathing pattern during exercise in HF patients. These results suggest cardiac size may pose a significant constraint on the lungs during exercise and may contribute to tachypnoeic breathing.

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