Noninvasive Ventilation Before Maximum Exercise Test Increases Exercise Tolerance in Subjects With Heart Failure: A Crossover Study

Carvalho, Larissa de Andrade; Brandão, Daniella Cunha; Campos, Shirley Lima; Vidal, Tainá Maria de Souza; Remígio, Maria Inês; Martins, Sílvia Marinho; Andrade, Armèle Dornelas de

doi:10.1016/j.apmr.2016.09.129

Cited by 4 publications

(3 citation statements)

References 32 publications

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“…In our study, we found that NIPPV provided an increase of 6 mlO 2 •kg −1 •min −1 in VO 2 , 9 ml/min in VE , and 2% in SpO 2 when compared with SHAM ventilation during exercise. Currently, a minimum detectable difference of 1.02 mlO 2 •kg −1 •min −1 for VO 2 indicates a successful intervention (21), a threshold well-surpassed in the current study supporting the use of NIPPV during exercise in patients with COPD-HF. We believe that the results of the current study can be explained by the following: (1) an increase in pleural pressure fluctuations as a result of increased ventilatory demand during exercise; and (2) the increase of 8-12 cmH 2 O in IPAP and Two-way variance analysis with Bonferroni post-hoc.…”

Section: Effect Of Nippv On Metabolic and Ventilatory Variablessupporting

confidence: 58%

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Can Non-invasive Ventilation Modulate Cerebral, Respiratory, and Peripheral Muscle Oxygenation During High-Intensity Exercise in Patients With COPD-HF?

Goulart

Caruso

Araújo

et al. 2022

Front. Cardiovasc. Med.

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AimTo evaluate the effect of non-invasive positive pressure ventilation (NIPPV) on (1) metabolic, ventilatory, and hemodynamic responses; and (2) cerebral (Cox), respiratory, and peripheral oxygenation when compared with SHAM ventilation during the high-intensity exercise in patients with coexisting chronic obstructive pulmonary disease (COPD) and heart failure (HF).Methods and ResultsOn separate days, patients performed incremental cardiopulmonary exercise testing and two constant-work rate tests receiving NIPPV or controlled ventilation (SHAM) (the bilevel mode—Astral 150) in random order until the limit of tolerance (Tlim). During exercise, oxyhemoglobin (OxyHb+Mb) and deoxyhemoglobin (DeoxyHb+Mb) were assessed using near-infrared spectroscopy (Oxymon, Artinis Medical Systems, Einsteinweg, The Netherlands). NIPPV associated with high-intensity exercise caused a significant increase in exercise tolerance, peak oxygen consumption (V·O2 in mlO2·kg−1·min−1), minute ventilation peak (V·E in ml/min), peak peripheral oxygen saturation (SpO2, %), and lactate/tlim (mmol/s) when compared with SHAM ventilation. In cerebral, respiratory, and peripheral muscles, NIPPV resulted in a lower drop in OxyHb+Mb (p < 0.05) and an improved deoxygenation response DeoxyHb+Mb (p < 0.05) from the half of the test (60% of Tlim) when compared with SHAM ventilation.ConclusionNon-invasive positive pressure ventilation during constant work-rate exercise led to providing the respiratory muscle unloading with greater oxygen supply to the peripheral muscles, reducing muscle fatigue, and sustaining longer exercise time in patients with COPD-HF.

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Section: Effect Of Nippv On Metabolic and Ventilatory Variablessupporting

confidence: 58%

“…4-6 cmH 2 O in PEEP increased the cardiac function and improved blood supply, both favorably impacting the exercise performance (21).…”

Section: Effect Of Nippv On Metabolic and Ventilatory Variablesmentioning

confidence: 98%

Can Non-invasive Ventilation Modulate Cerebral, Respiratory, and Peripheral Muscle Oxygenation During High-Intensity Exercise in Patients With COPD-HF?

Goulart

Caruso

Araújo

et al. 2022

Front. Cardiovasc. Med.

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“…39 The gain in exercise capacity indicated by the maximum V O 2 increase of 4.9 mL/kg/min observed in this study is probably due to the use of NIV because the use of positive pressure tends to improve cardiac function and regional vascular distribution, in addition to reducing the transmural pressure gradient and the left ventricular afterload, which allows the improvement of blood supply to the periphery, subsequently allowing individuals to gain exercise capacity. 40 Carvalho et al 40 showed that the minimum detectable difference calculated for maximum V O 2 was 1.02 mL/kg/min. A maximum V O 2 increase of 2.2 mL/kg/min was observed, corresponding to a gain of 12.3% in the NIV phase compared with the control phase.…”

Section: Additional Effects Of Bi-level Niv After a 6-week Physical Tmentioning

confidence: 99%

Noninvasive Ventilation as an Important Adjunct to an Exercise Training Program in Subjects With Moderate to Severe COPD

et al. 2018

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A 6-week physical training program alone can improve tolerance for exercise and quality of life, in addition to reducing the risk of mortality. However, NIV associated with a physical training program was shown to have an additive beneficial effect on powerful prognostic markers (maximum V̇ and circulatory power) and to reduce symptoms and improve oxygen saturation in subjects with moderate to very severe COPD.

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Noninvasive Ventilation Accelerates Oxygen Uptake Recovery Kinetics in Patients With Combined Heart Failure and Chronic Obstructive Pulmonary Disease

Mazzuco

Souza

Goulart

et al. 2020

Journal of Cardiopulmonary Rehabilitation and Prevention

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Purpose: Oxygen uptake (V˙o2) recovery kinetics appears to have considerable value in the assessment of functional capacity in both heart failure (HF) and chronic obstructive pulmonary disease (COPD). Noninvasive positive pressure ventilation (NIPPV) may benefit cardiopulmonary interactions during exercise. However, assessment during the exercise recovery phase is unclear. The purpose of this investigation was to explore the effects of NIPPV on V˙o2, heart rate, and cardiac output recovery kinetics from high-intensity constant-load exercise (CLE) in patients with coexisting HF and COPD. Methods: Nineteen males (10 HF/9 age- and left ventricular ejection fraction-matched HF-COPD) underwent 2 high-intensity CLE tests at 80% of peak work rate to the limit of tolerance (Tlim), receiving either sham ventilation or NIPPV. Results: Despite greater V˙o2 recovery kinetics on sham, HF-COPD patients presented with a faster exponential time constant τ (76.4 ± 14.0 sec vs 62.8 ± 15.2 sec, P < .05) and mean response time (MRT) (86.1 ± 19.1 sec vs 68.8 ± 12.0 sec, P < .05) with NIPPV and greater ΔNIPPV-sham (τ: 5.6 ± 19.5 vs −25.2 ± 22.4, P < .05; MRT: 4.1 ± 32.2 vs −26.0 ± 19.2, P < .05) compared with HF. There was no difference regarding Tlim between sham and NIPPV in both groups (P < .05). Conclusion: Our results suggest that NIPPV accelerated the V˙o2 recovery kinetics following high-intensity CLE to a greater extent in patients with coexisting HF and COPD compared with HF alone. NIPPV should be considered when the objective is to apply high-intensity interval exercise training as an adjunct intervention during a cardiopulmonary rehabilitation program.

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Noninvasive Ventilation Before Maximum Exercise Test Increases Exercise Tolerance in Subjects With Heart Failure: A Crossover Study

Cited by 4 publications

References 32 publications

Can Non-invasive Ventilation Modulate Cerebral, Respiratory, and Peripheral Muscle Oxygenation During High-Intensity Exercise in Patients With COPD-HF?

Can Non-invasive Ventilation Modulate Cerebral, Respiratory, and Peripheral Muscle Oxygenation During High-Intensity Exercise in Patients With COPD-HF?

Noninvasive Ventilation as an Important Adjunct to an Exercise Training Program in Subjects With Moderate to Severe COPD

Noninvasive Ventilation Accelerates Oxygen Uptake Recovery Kinetics in Patients With Combined Heart Failure and Chronic Obstructive Pulmonary Disease

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