Relative contribution of resting haemodynamic profile and lung function to exercise tolerance in male patients with chronic heart failure. Issue 2 (1st February 2001)

• Record Type: Journal Article
• Authors: Faggiano, P; D'Aloia, A; Gualeni, A; Giordano, A
• Is Part Of: Heart. Volume 85:Issue 2(2001)
• Page Start: 179
• Page End: 184
• Publication Date: 2001-02-01
• Subjects: heart failure -- exercise -- pulmonary function -- alveolar–capillary diffusing capacity; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heart.85.2.179
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : 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 (V˙o 2 ) was 13 (3.9) ml/kg/min. Among resting haemodynamic variables only cardiac index showed a significant correlation with peakV˙o 2 . There were no differences in haemodynamic variables between patients with peakV˙o 2 ⩽ or > 14 ml/kg/min. There was a moderate correlation (p < 0.05) between several pulmonary function variables and peak V˙o 2 . Forced vital capacity (3.5 (0.9) v 3.2 (0.8) l, p < 0.05) and DLCO (21.6 (6.9) v 17.7 (5.5) ml/mm Hg/min, p < 0.05) were higher in patients with peakV˙o 2 > 14 ml/kg/min than in those with peak V˙o 2 ⩽ 14 ml/kg/min. Using a stepwise regression analysis, the respiratory and haemodynamic variables which correlated significantly with peakV˙o 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 exerciseV˙o 2 . In particular, lung diffusing capacity and respiratory muscle function seem to affect exercise tolerance during heart failure.