|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1994; 24:972-981 © 1994 by the American College of Cardiology Foundation |
Cardiovascular Section, Veterans Administration Medical Center, Philadelphia, Pennsylvania.
OBJECTIVES. We sought to investigate whether reduced respiratory muscle endurance contributes to increased dyspnea and decreased exercise capacity in patients with chronic heart failure. BACKGROUND. In patients with heart failure, the sensation of dyspnea may be related to abnormalities of respiratory muscle function, such as diminished strength or endurance, or both. METHODS. Respiratory muscle endurance was assessed by measuring maximal sustainable ventilatory capacity in 15 patients with congestive heart failure and 8 normal subjects using progressive isocapnic hyperpnea. Near-infrared spectroscopy of an accessory respiratory muscle, Borg scale recordings of perceived dyspnea, time in inspiration, time per breath and minute ventilation were measured. Exercise testing with measurement of oxygen consumption was also performed. RESULTS. Maximal voluntary ventilation (normal subjects 167 +/- 40, heart failure group 89 +/- 31 liters/min) and maximal sustainable ventilatory capacity (normal subjects 90 +/- 23, heart failure group 53 +/- 22 liters/min) were significantly reduced in patients with heart failure (both p < 0.05). No significant accessory respiratory muscle deoxygenation was observed in either group. Borg scale recordings at maximal sustainable ventilatory capacity were comparable in both groups. At rest, the inspiratory duty cycle (i.e., time in inspiration divided by the time per breath) was comparable in the two groups (normal subjects 0.34 +/- 0.09, heart failure group 0.37 +/- 0.12, p = NS). However at maximal sustainable ventilatory capacity, only normal subjects had a significant increase in the inspiratory duty cycle (normal subjects 0.49 +/- 0.04, heart failure group 0.36 +/- 0.10, p < 0.05). This finding suggests obstruction to airflow in patients with congestive heart failure. Values for peak exercise minute ventilation did not differ significantly from values in maximal sustainable ventilatory capacity in either group and were significantly correlated (r = 0.84, p < 0.0001). CONCLUSION. Respiratory muscle endurance as assessed by maximal sustainable ventilatory capacity is reduced in patients with heart failure.
This article has been cited by other articles:
|
|
 |
|
  S. Jelic and T. H. Le Jemtel Diagnostic Usefulness of B-Type Natriuretic Peptide and Functional Consequences of Muscle Alterations in COPD and Chronic Heart Failure. Chest, October 1, 2006; 130(4): 1220 - 1230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G Burniston, A. Saini, L.-B. Tan, and D. F Goldspink Angiotensin II induces apoptosis in vivo in skeletal, as well as cardiac, muscle of the rat Exp Physiol, September 1, 2005; 90(5): 755 - 761. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. Goldspink, J. G. Burniston, G. M. Ellison, W. A. Clark, and L.-B. Tan Catecholamine-induced apoptosis and necrosis in cardiac and skeletal myocytes of the rat in vivo: the same or separate death pathways? Exp Physiol, July 1, 2004; 89(4): 407 - 416. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N Hart, M T Kearney, N B Pride, M Green, F Lofaso, A M Shah, J Moxham, and M I Polkey Inspiratory muscle load and capacity in chronic heart failure Thorax, June 1, 2004; 59(6): 477 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. K. Gehlbach and E. Geppert The Pulmonary Manifestations of Left Heart Failure Chest, February 1, 2004; 125(2): 669 - 682. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Laghi and M. J. Tobin Disorders of the Respiratory Muscles Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K K A Witte, S D R Thackray, N P Nikitin, J G F Cleland, and A L Clark Pattern of ventilation during exercise in chronic heart failure Heart, June 1, 2003; 89(6): 610 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T.J. Kufel, L.A. Pineda, R.G. Junega, R. Hathwar, and M.J. Mador Diaphragmatic function after intense exercise in congestive heart failure patients Eur. Respir. J., December 1, 2002; 20(6): 1399 - 1405. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Beniaminovitz, C. C. Lang, J. LaManca, and D. M. Mancini Selective low-level leg muscle training alleviates dyspnea in patients with heart failure J. Am. Coll. Cardiol., November 6, 2002; 40(9): 1602 - 1608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
ATS/ERS Statement on Respiratory Muscle Testing Am. J. Respir. Crit. Care Med., August 15, 2002; 166(4): 518 - 624. [Full Text] [PDF]
|
|
|
|
|
|
A. J S Coats HEART FAILURE: What causes the symptoms of heart failure? Heart, November 1, 2001; 86(5): 574 - 578. [Full Text] [PDF]
|
|
|
|
|
|
P. D. HUGHES, N. HART, C.-H. HAMNEGÅRD, M. GREEN, A. J. S. COATS, J. MOXHAM, and M. I. POLKEY Inspiratory Muscle Relaxation Rate Slows during Exhaustive Treadmill Walking in Patients with Chronic Heart Failure Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1400 - 1403. [Abstract] [Full Text]
|
|
|
|
 |
|
 F. J. Meyer, M. M. Borst, C. Zugck, A. Kirschke, D. Schellberg, W. Kubler, and M. Haass Respiratory Muscle Dysfunction in Congestive Heart Failure : Clinical Correlation and Prognostic Significance Circulation, May 1, 2001; 103(17): 2153 - 2158. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Recommendations for exercise training in chronic heart failure patients Eur. Heart J., January 2, 2001; 22(2): 125 - 135. [PDF]
|
|
|
|
 |
|
 N. G. MacFarlane, G. M. Darnley, and G. L. Smith Cellular basis for contractile dysfunction in the diaphragm from a rabbit infarct model of heart failure Am J Physiol Cell Physiol, April 1, 2000; 278(4): C739 - C746. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Nanas, J. Nanas, C. Kassiotis, G. Alexopoulos, A. Samakovli, J. Kanakakis, E. Tsolakis, and C. Roussos Respiratory Muscles Performance Is Related to Oxygen Kinetics During Maximal Exercise and Early Recovery in Patients With Congestive Heart Failure Circulation, August 3, 1999; 100(5): 503 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Opasich, N. Ambrosino, G. Felicetti, R. Aquilani, E. Pasini, D. Bergitto, A. Mazza, F. Cobelli, and L. Tavazzi Heart failure-related myopathy. Clinical and pathophysiological insights Eur. Heart J., August 2, 1999; 20(16): 1191 - 1200. [Abstract] [PDF]
|
|
|
|
|
|
P. D. HUGHES, M. I. POLKEY, M. LOU HARRIS, A. J. S. COATS, J. MOXHAM, and M. GREEN Diaphragm Strength In Chronic Heart Failure Am. J. Respir. Crit. Care Med., August 1, 1999; 160(2): 529 - 534. [Abstract] [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
