Details

Autor(en) / Beteiligte

• Apostolo, Anna
• Laveneziana, PierAntonio
• Palange, Paolo
• Agalbato, Cecilia
• Molle, Roberta
• Popovic, Dejana
• Bussotti, Maurizio
• Internullo, Mattia
• Sciomer, Susanna
• Bonini, Matteo
• Alencar, Maria Clara
• Godinas, Laurent
• Arbex, Flavio
• Garcia, Gilles
• Neder, J. Alberto
• Agostoni, Piergiuseppe

Titel

Impact of chronic obstructive pulmonary disease on exercise ventilatory efficiency in heart failure

Ist Teil von

• International journal of cardiology, 2015, Vol.189, p.134-140

Ort / Verlag

Netherlands

Erscheinungsjahr

2015

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Abstract Background Heart failure (HF) and chronic obstructive pulmonary disease (COPD) coexistence increases morbidity and mortality. The intercept of ventilation ( V ˙ E int ) on the V ˙ E vs. carbon dioxide production ( V ˙ CO2 ) relationship during exercise has been found to vary in proportion with dead space (VD) in HF. Considering that increased VD is the key pathophysiological abnormality in COPD but a secondary finding in HF we hypothesized that a high V ˙ E int would be useful in suggesting COPD as HF co-morbidity. Our aim was to assess whether an elevated V ˙ E int suggests the presence of COPD in HF. Methods In a multicenter retrospective study, the V ˙ E– V ˙ CO2 relationship was analyzed both as slope and intercept in HF (n = 108), HF–COPD (n = 106) and COPD (n = 95). Patients with pulmonary arterial hypertension (PAH) (n = 85) and healthy subjects (HF) (n = 56) served as positive and negative controls relative to V ˙ E– V ˙ CO2 abnormalities, respectively. Results Slope and V ˙ E int varied in opposite directions in all groups (p < 0.05) being V ˙ E– V ˙ CO2 slope highest and lowest in PAH and healthy subjects, respectively. No slope differences were observed among HF, HF–COPD and COPD (32 ± 7, 31 ± 7, and 31 ± 6, respectively). V ˙ E int was higher in HF–COPD and COPD compared to HF, PAH and controls (4.8 ± 2.4 L/min, 5.9 ± 3.0 L/min, 3.0 ± 2.6 L/min, 2.3 ± 3.3 L/min and 3.9 ± 2.5 L/min, respectively; p < 0.01). A V ˙ E int ≥ 4.07 L/min identified patients with high probability of having COPD or HF–COPD (sensitivity of 71.6% and specificity of 72.0%). Conclusion These data provide novel evidence that a high V ˙ E int (≥ 4.07 L/min) should be valued to suggest coexistent COPD in HF patients.