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. 2001 Feb;85(2):179–184. doi: 10.1136/heart.85.2.179

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

P Faggiano 1, A D'Aloia 1, A Gualeni 1, A Giordano 1
PMCID: PMC1729632  PMID: 11156669

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 (V̇O2) was 13 (3.9) ml/kg/min. Among resting haemodynamic variables only cardiac index showed a significant correlation with peak V̇O2. There were no differences in haemodynamic variables between patients with peak V̇O2 ⩽ or > 14 ml/kg/min. There was a moderate correlation (p < 0.05) between several pulmonary function variables and peak V̇O2. 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 peak V̇O2 > 14 ml/kg/min than in those with peak V̇O2 ⩽ 14 ml/kg/min. Using a stepwise regression analysis, the respiratory and haemodynamic variables which correlated significantly with peak V̇O2 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 V̇O2. In particular, lung diffusing capacity and respiratory muscle function seem to affect exercise tolerance during heart failure.


Keywords: heart failure; exercise; pulmonary function; alveolar-capillary diffusing capacity

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Figure 1  .

Figure 1  

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Linear regression analysis between peak exercise oxygen uptake (V̇O2 peak) on the x axis and several haemodynamic variables on the y axis. See text for details.

Figure 2  .

Figure 2  

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Linear regression analysis between peak exercise oxygen uptake (V̇O2 peak) on the x axis and lung function indices on the y axis. See text for details.

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