Relative contribution of resting haemodynamic profile and lung function to exercise tolerance in male patients with chronic heart failure

被引:19
作者
Faggiano, P [1 ]
D'Aloia, A [1 ]
Gualeni, A [1 ]
Giordano, A [1 ]
机构
[1] S Maugeri Fdn, Cardiac Rehabil Div, Gussago, Italy
关键词
heart failure; exercise; pulmonary function; alveolar-capillary diffusing capacity;
D O I
10.1136/heart.85.2.179
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective-To clarify the relative contribution of resting haemodynamic profile and pulmonary function to exercise capacity in patients with heart failure. Setting-Cardiology department and cardiac rehabilitation unit in a tertiary centre. Design-161 male patients (mean (SD) age 59 (9) years) with heart failure (New York Heart Association class II-IV, left ventricular ejection fraction 23 (7)%) underwent spirometry, alveolar capillary diffusing capacity (DLCO), and mouth inspiratory and expiratory pressures (MIP, MEP, respectively, in 100 patients). Right heart catheterisation and a symptom limited cardiopulmonary exercise test were performed in 137 patients within 3-4 days. Results-Mean peak exercise oxygen consumption (Vo(2)) was 13 (3.9) ml/kg/min. Among resting haemodynamic variables only cardiac index showed a significant correlation with peak Vo(2). There were no differences in haemodynamic variables between patients with peak Vo(2) less than or equal to or > 14 ml/kg/min. There was a moderate correlation (p < 0.05) between several pulmonary function variables and peak Vo(2). Forced vital capacity (3.5 (0.9) <nu> 3.2 (0.8) l, p < 0.05) and DLCO (21.6 (6.9) <nu> 17.7 (5.5) ml/mm Hg/min, p < 0.05) were higher in patients with peak Vo(2) > 14 ml/kg/ min than in those with peak Vo(2) less than or equal to 14 ml/kg/min. Using a stepwise regression analysis, the respiratory and haemodynamic variables which correlated significantly with peak Vo(2) were DLCO, MEP, and cardiac index, with an overall R value of 0.63. Conclusions-The data confirm previous studies showing a poor correlation between resting indices of cardiac function and exercise capacity in heart failure. However, several pulmonary function variables were related to peak exercise VOL In particular, lung diffusing capacity and respiratory muscle function seem to affect exercise tolerance during heart failure.
引用
收藏
页码:179 / 184
页数:6
相关论文
共 36 条
[1]   BREATHING PATTERN, VENTILATORY DRIVE AND RESPIRATORY MUSCLE STRENGTH IN PATIENTS WITH CHRONIC HEART-FAILURE [J].
AMBROSINO, N ;
OPASICH, C ;
CROTTI, P ;
COBELLI, F ;
TAVAZZI, L ;
RAMPULLA, C .
EUROPEAN RESPIRATORY JOURNAL, 1994, 7 (01) :17-22
[2]   Alteration of the alveolar-capillary membrane diffusing capacity in chronic left heart disease [J].
Assayag, P ;
Benamer, H ;
Aubry, P ;
de Picciotto, C ;
Brochet, E ;
Besse, S ;
Camus, F .
AMERICAN JOURNAL OF CARDIOLOGY, 1998, 82 (04) :459-464
[3]   IMPROVEMENT IN EXERCISE PERFORMANCE BY INHALATION OF METHOXAMINE IN PATIENTS WITH IMPAIRED LEFT-VENTRICULAR FUNCTION [J].
CABANES, L ;
COSTES, F ;
WEBER, S ;
REGNARD, J ;
BENVENUTI, C ;
CASTAIGNE, A ;
GUERIN, F ;
LOCKHART, A .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (25) :1661-1665
[4]   Exercise limitation in chronic heart failure: Central role of the periphery [J].
Clark, AL ;
PooleWilson, PA ;
Coats, AJS .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1996, 28 (05) :1092-1102
[5]   Contribution of lung function to exercise capacity in patients with chronic heart failure [J].
Dimopoulou, I ;
Tsintzas, OK ;
Daganou, M ;
Cokkinos, DV ;
Tzelepis, GE .
RESPIRATION, 1999, 66 (02) :144-149
[6]   ALTERATIONS OF SKELETAL-MUSCLE IN CHRONIC HEART-FAILURE [J].
DREXLER, H ;
RIEDE, U ;
MUNZEL, T ;
KONIG, H ;
FUNKE, E ;
JUST, H .
CIRCULATION, 1992, 85 (05) :1751-1759
[7]  
European Respiratory Society, 1993, EUR RESP J S16, V6, P41
[8]   Hemodynamic profile of submaximal constant workload exercise in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy [J].
Faggiano, P ;
D'Aloia, A ;
Gualeni, A ;
Giordano, A .
AMERICAN JOURNAL OF CARDIOLOGY, 1998, 81 (04) :437-442
[9]   Dobutamine-induced changes in pulmonary artery pressure in patients with congestive heart failure and their relation to abnormalities of lung diffusing capacity [J].
Faggiano, P ;
D'Aloia, A ;
Gualeni, A ;
Ambrosino, N ;
Pagani, M ;
Giordano, A .
AMERICAN JOURNAL OF CARDIOLOGY, 1998, 82 (10) :1296-+
[10]   ABNORMALITIES OF PULMONARY-FUNCTION IN CONGESTIVE-HEART-FAILURE [J].
FAGGIANO, P .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 1994, 44 (01) :1-8