Impaired ventilatory efficiency in chronic heart failure: Possible role of pulmonary vasoconstriction

Reindl, I.; Wernecke, Klaus‐Dieter; Opitz, Christian; Wensel, Roland; König, Dirk; Dengler, Thomas J.; Schimke, Ingolf; Kleber, Franz X.

doi:10.1016/s0002-8703(98)70121-8

Cited by 145 publications

(106 citation statements)

References 26 publications

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“…O FTT pode ser usado como um medidor indirecto da perfusão pulmonar e num estudo prévio, efectuado pelo nosso grupo, estabelecemos uma correlação signifi cativa entre o FTT e a pressão capilar pulmonar (PCP) 9 . Assim, estes resultados estão de acordo com os obtidos por Reindl et al 12 que demonstraram uma correlação positiva entre os valores em repouso da PCP e da pressão arterial pulmonar e o dVE/ VCO 2 .…”

Section: Discussionunclassified

Fluido torácico total – Um possível determinante da eficácia ventilatória em doentes com insuficiência cardíaca

Valente

Feliciano

Soares

et al. 2011

Revista Portuguesa de Cardiologia

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Section: Discussionunclassified

Fluido torácico total – Um possível determinante da eficácia ventilatória em doentes com insuficiência cardíaca

Valente

Feliciano

Soares

et al. 2011

Revista Portuguesa de Cardiologia

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“…However, when blood gases were obtained during exercise, both Pa,O 2 at AT (r50.404, p50.005) and Pa,CO 2 at AT (r50.479, p,0.001) did correlate significantly with peak V'O 2 . It is likely that both a higher Pa,O 2 and a higher Pa,CO 2 during exercise are indicators of a more effective pulmonary perfusion [7,8].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of blood gas analyses in patients with idiopathic pulmonary arterial hypertension

Hoeper¹,

Pletz²,

Golpon³

et al. 2007

European Respiratory Journal

145

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Blood gas abnormalities in patients with idiopathic pulmonary arterial hypertension (IPAH) may be related to disease severity and prognosis.The present authors performed a 12-yr retrospective analysis assessing arterialised capillary blood gases, haemodynamics, exercise variables and survival in 101 patients with IPAH.At baseline, arterial oxygen tension (Pa,O 2 ) and carbon dioxide arterial tension (Pa,CO 2 ) were 9.17¡1.86 and 4.25¡0.532 kPa, respectively. While Pa,O 2 was not associated with survival, a low Pa,CO 2 was a strong and independent prognostic marker. When patients were divided according to a baseline Pa,CO 2 value above or below 4.25 kPa, a cut-off value determined by receiver operating characteristics analysis, survival rates were 98 and 86% at 1 yr, 82 and 69% at 2 years, 80 and 51% at 3 yrs, 77 and 41% at 5 yrs, and 65 and 12% at 8 yrs, respectively. Pa,CO 2 after 3 months of medical therapy was strongly associated with survival. Hypocapnia at rest and during exercise correlated with low cardiac output, low peak oxygen uptake and reduced ventilatory efficacy. Multiple regression analysis revealed that 6-min walking distance, right atrial pressure and Pa,CO 2 were independently associated with survival.In patients with idiopathic pulmonary arterial hypertension, hypocapnia (carbon dioxide arterial tension ,4.25 kPa) is an independent marker of mortality.

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“…[27][28][29][30] However, this ventilatory limitation with dyspnoea is more exaggerated in patients with HFpEF, followed by intolerance due to increase of the PCWP.…”

mentioning

confidence: 99%

The combined exercise stress echocardiography and cardiopulmonary exercise test for identification of masked heart failure with preserved ejection fraction in patients with hypertension

Nedeljković

Banović

Stepanović

et al. 2015

Eur J Prev Cardiolog

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Background: Heart failure with preserved ejection fraction (HFpEF) is commonly associated with hypertension (HTN). However, resting echocardiography (ECHO) can underestimate the severity of disease. Exercise stress echocardiography (ESE) and the cardiopulmonary exercise testing (CPX) appeared to be useful tests in dynamic assessment of HFpEF. The value of combined exercise stress echocardiography cardiopulmonary testing (ESE-CPX) in the identification of masked HFpEF is still undetermined. Objective: The purpose of this study was to analyse the value of the combined ESE-CPX in the identification of masked HFpEF in patients with HTN, dyspnoea and normal resting left ventricular (LV) systolic and diastolic function. Methodology: We studied 87 patients with HTN, exertional dyspnoea and normal resting LV function. They all underwent ESE-CPX testing (supine bicycle, ramp protocol, 15 W/min). ECHO measurements were performed at rest, and at peak load. Achievement of peak E/e' ratio>15 was a marker for masked HFpEF. Results: Increase of E/e'>15 occurred in 8/87 patients (9.2%) during ESE-CPX. Those patients had the lower peak VO2 (p ¼ 0.012), the lower VO2 at anaerobic threshold (p ¼ 0.025), the lower workload (p ¼ 0.026), the lower peak partial pressure end tidal carbon dioxide (PetCO2) (p < 0.0001), and the higher VE/VCO2 slope (p < 0.0001) which was an independent multivariate predictor of HFpEF (p ¼ 0.021), with the cut-off value of 32.95 according to the receiveroperator characteristic (ROC) curve (sensitivity (Sn) 100%, specificity (Sp) 90%). Conclusion: The combined ESE-CPX test is feasible and reliable test that can unmask HFpEF and may become an important aid in the early diagnosis of HFpEF, excluding the other causes of exertional dyspnoea.

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Impaired ventilatory efficiency in chronic heart failure: Possible role of pulmonary vasoconstriction

Cited by 145 publications

References 26 publications

Fluido torácico total – Um possível determinante da eficácia ventilatória em doentes com insuficiência cardíaca

Fluido torácico total – Um possível determinante da eficácia ventilatória em doentes com insuficiência cardíaca

Prognostic value of blood gas analyses in patients with idiopathic pulmonary arterial hypertension

The combined exercise stress echocardiography and cardiopulmonary exercise test for identification of masked heart failure with preserved ejection fraction in patients with hypertension

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