The resistive and elastic work of breathing during exercise in patients with chronic heart failure

Troy J. Cross, Surendan Sabapathy, Kenneth C. Beck, Norman R. Morris, Bruce D. Johnson

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Patients with heart failure (HF) display numerous derangements in ventilatory function, which together serve to increase the work of breathing (W b) during exercise. However, the extent to which the resistive and elastic properties of the respiratory system contribute to the higher W b in these patients is unknown. We quantified the resistive and elastic W b in patients with stable HF (n=9; New York Heart Association functional class I-II) and healthy control subjects (n=9) at standardised levels of minute ventilation (V′E) during graded exercise. Dynamic lung compliance was systematically lower for a given level of V′E in HF patients than controls (p<0.05). HF patients displayed slightly higher levels of inspiratory elastic W b with greater amounts of ventilatory constraint and resistive W b than control subjects during exercise (p<0.05). Our data indicates that the higher W b in HF patients is primarily due to a greater resistive, rather than elastic, load to breathing. The greater resistive W b in these patients probably reflects an increased hysteresivity of the airways and lung tissues. The marginally higher inspiratory elastic W b observed in HF patients appears related to a combined decrease in the compliances of the lungs and chest wall. The clinical and physiological implications of our findings are discussed. Copyright

Original languageEnglish (US)
Pages (from-to)1449-1457
Number of pages9
JournalEuropean Respiratory Journal
Volume39
Issue number6
DOIs
StatePublished - Jun 1 2012

Keywords

  • Heart failure
  • Respiratory mechanics
  • Work of breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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