Physiological and sensory consequences of exercise oscillatory ventilation in heart failure-COPD

Show simple item record Rocha, Alcides [UNIFESP] Arbex, Flavio Ferlin [UNIFESP] Alencar, Maria Clara Noman de [UNIFESP] Sperandio, Priscila Abreu [UNIFESP] Hirai, Daniel Müller [UNIFESP] Berton, Danilo C. O'Donnell, Denis E. Neder, Jose Alberto [UNIFESP] 2020-07-31T12:47:09Z 2020-07-31T12:47:09Z 2016
dc.identifier.citation International Journal Of Cardiology. Clare, v. 224, p. 447-453, 2016.
dc.identifier.issn 0167-5273
dc.description.abstract Background: Exercise oscillatory ventilation (EOV) is associatedwith poor ventilatory efficiency and higher operating lung volumes in heart failure. These abnormalitiesmay be particularly deleterious to dyspnea and exercise tolerance in mechanically-limited patients, e.g. those with coexistent COPD. Methods: Ventilatory, gas exchange and sensory responses to incremental exercise were contrasted in 68 heart failure-COPD patients (12 EOV+). EOV was established by standard criteria. Results: Compared to EOV-, EOV+ had lower exercise capacity, worse ventilatory inefficiency and higher peak dyspnea scores (p < 0.05). Peak capillary PCO2 (PcCO2) was higher and end-tidal CO2 (PETCO2) was lower in EOV+. Thus, greater (i.e., more positive) P(c-ET) CO2 and dead space/tidal volume values were found in these patients compared to EOV- (p < 0.05). Ventilatory inefficiency was related to increased dead space/tidal volumein EOV+ (r = 0.74 en
dc.description.abstract p < 0.01). Owing to higher operating lung volumes, inspiratory reserve volume (IRV) decreased to a greater extent in EOV+. Tidal volume oscillations consistently ceased when a "critical" IRV was reached (similar to 0.3-0.5 L) en
dc.description.abstract thereafter, PcCO2 stabilized or increased and dyspnea scores rose sharply. Exercise capacity was closely related to IRV decrements and peak dyspnea in EOV+ (r = -0.78 and 0.84, respectively en
dc.description.abstract p < 0.01). Conclusions: Dyspnea and exercise tolerance are negatively influenced by EOV in heart failure patients presenting with COPD as co-morbidity. Pharmacological and non-pharmacological interventions known to decrease EOV might prove particularly valuable to mitigate symptomburden and exercise intolerance in this specific heart failure group. (C) 2016 Elsevier Ireland Ltd. All rights reserved. en
dc.format.extent 447-453
dc.language.iso eng
dc.publisher Elsevier Ireland Ltd
dc.relation.ispartof International Journal Of Cardiology
dc.rights Acesso restrito
dc.subject Heart failure en
dc.subject COPD en
dc.subject Exertion en
dc.subject Ventilation en
dc.subject Lung mechanics en
dc.subject Dyspnea en
dc.title Physiological and sensory consequences of exercise oscillatory ventilation in heart failure-COPD en
dc.type Artigo
dc.description.affiliation Univ Fed Sao Paulo, Div Respirol, Pulm Funct & Clin Exercise Physiol Unit SEFICE, Sao Paulo, Brazil
dc.description.affiliation Queens Univ, Kingston Gen Hosp, Lab Clin Exercise Physiol, Kingston, ON, Canada
dc.description.affiliation Queens Univ, Kingston Gen Hosp, Resp Invest Unit, Kingston, ON, Canada
dc.description.affiliation Univ Fed Rio Grande do Sul, Div Respirol, Porto Alegre, RS, Brazil
dc.description.affiliationUnifesp Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Division of Respirology, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
dc.identifier.doi 10.1016/j.ijcard.2016.09.077
dc.description.source Web of Science
dc.identifier.wos WOS:000390471300081
dc.coverage Clare
dc.citation.volume 224


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