Respiratory drive and breathing pattern abnormalities are related to exercise intolerance in chronic heart failure patients

Tasoulis, Athanasios; Dimopoulos, Stavros; Repasos, Evangelos; Manetos, Christos; Tzanis, Giorgos; Sousonis, Vasileios; Papazachou, Ourania; Terrovitis, John; Nanas, Serafim

doi:10.1016/j.resp.2013.11.011

Cited by 7 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of ventilatory and gas exchange abnormalities are known to occur at rest and during exercise in patients with HFrEF [19, 20]. The current study demonstrated an elevated ventilatory response for a given metabolic load during exercise (increased V E /VCO 2 ), commonly referred to as reduced ventilatory efficiency [21].…”

Section: Discussionmentioning

confidence: 68%

Improved Ventilatory Efficiency with Locomotor Muscle Afferent Inhibition is Strongly Associated with Leg Composition in Heart Failure

Keller‐Ross

Johnson

Carter³

et al. 2016

International Journal of Cardiology

View full text Add to dashboard Cite

Background Skeletal muscle atrophy contributes to increased afferent feedback (group III and IV) and may influence ventilatory control (high VE/VCO2 slope) in heart failure (HF). Objective This study examined the influence of muscle mass on the change in VE/VCO2 with afferent neural block during exercise in HF. Methods 17 participants [9 HF (60±6 yrs) and 8 controls (CTL) (63±7 yrs, mean±SD)] completed 3 sessions. Session 1: dual energy x-ray absorptiometry and graded cycle exercise to volitional fatigue. Sessions 2 and 3: 5 min of constant-work cycle exercise (65% of peak power) randomized to lumbar intrathecal injection of fentanyl (afferent blockade) or placebo. Ventilation (VE) and gas exchange (oxygen consumption, VO2; carbon dioxide production, VCO2) were measured. Results Peak work and VO2 were lower in HF (p<0.05). Leg fat was greater in HF (34.4±3.0 and 26.3±1.8%) and leg muscle mass was lower in HF (63.0±2.8 and 70.4±1.8%, respectively, p<0.05). VE/VCO2 slope was reduced in HF during afferent blockade compared with CTL (−18.8±2.7 and −1.4±2.0%, respectively, p=0.02) and was positively associated with leg muscle mass (r2=0.58, p<0.01) and negatively associated with leg fat mass (r2=0.73, p<0.01) in HF only. Conclusions HF patients with the highest fat mass and the least leg muscle mass had the greatest improvement in VE/VCO2 with afferent blockade with leg fat mass being the only predictor for the improvement in VE/VCO2 slope. Both leg muscle mass and fat mass are important contributors to ventilatory abnormalities and strongly associated to improvements in VE/VCO2 slope with locomotor afferent inhibition in HF.

show abstract

Section: Discussionmentioning

confidence: 68%

Improved Ventilatory Efficiency with Locomotor Muscle Afferent Inhibition is Strongly Associated with Leg Composition in Heart Failure

Keller‐Ross

Johnson

Carter³

et al. 2016

International Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…1 Patients with CHF present a wide range of symptoms, which comprise skeletal (and respiratory) muscle fatigue and dyspnea on exertion, leading to limited exercise capacity and impaired quality of life. [2][3] CHF is one of the most frequent causes of hospitalization and death worldwide. The prevalence of CHF is approximately 1-2% and increases to ≥10% among people over 70 years of age.…”

Section: Introductionmentioning

confidence: 99%

The acute effect of respiratory muscle training on microcirculation in patients with chronic heart failure

Katsoula

Karatzanos

Rovina

et al. 2023

HRJ

View full text Add to dashboard Cite

Background: Patients with chronic heart failure (CHF) present microcirculation alterations and vascular endothelial dysfunction. Exercise training programs have been shown to improve the functional status of these patients, however less is known yet about the acute systemic effect of exercise on peripheral muscle microcirculation. The aim of the present study was to investigate the acute effect of a respiratory muscle exercise bout on the microcirculation of non-exercising muscles (systemic effect). Materials and Methods: Thirty-four (30♂/4♀) stable CHF patients, with a mean age of61.4±9.2 years, ejection fraction (EF): 33.9±7.8%, maximal inspiratory pressure (MIP): 78.2±27.1 cmH2O, VO2max: 17.5±4.05 ml/kg/min, VE/VCO2 slope: 32.7±6.4 and a New York Heart Association classification (NYHA) ≥ ΙΙ participated in the study. Microcirculatory assessment was performed at rest and immediately after the respiratory exercise program (5 sets/10 repetitions, training load: 60% of MIP). Basal tissue oxygen saturation (StO2),oxygen consumption rate (OCR) and reperfusion rate (RR) were measured utilizing near-infrared spectroscopy(NIRS) at the thenar muscle along with the vascular occlusion test (VOT). Results: RR (%/min), following the release of vascular occlusion, as well as OCR (%/min) increased after the respiratory exercise program (from 3.4±1.6 to 3.9±1.7, p=0.007, and from 12.7±3.8 to 13.2±3.9, p=0.021 respectively), whereas the corresponding basal StO2values difference did not reach the level of statistical significance (from 85.5±6.4. to 84.7±6.2, p=0.065). Conclusions: In the present study, concerning patients with CHF, after an acute respiratory exercise bout, dynamic microcirculatory indices assessed by NIRS in peripheral, non-exercising muscles, were significantly altered.

show abstract

“…[3][4][5] Also, CHF patients demonstrate increased respiratory drive at rest and abnormal breathing pattern during exercise which is associated with disease severity. 6 Moreover, patients with CHF present impaired inspiratory muscle strength and endurance, an additional factor which is associated with limited exercise and poor prognosis. 7 There is evidence of benefits from IMT applied in CHF patients, including improvement of respiratory muscle strength, functional capacity, ventilation, quality of life and decreased dyspnea.…”

Section: Introductionmentioning

confidence: 99%

The Benefits of Inspiratory Muscle Training in Heart Failure Patients – A Systematic Review

Katsoula

Vasileiadis

Routsi

et al. 2022

HRJ

View full text Add to dashboard Cite

Background: Patients with heart failure (HF) have impaired function of respiratory system and frequently experience dyspnea. Inspiratory muscle training (IMT) offers an alternative way of exercise with a lot of benefits for HF patients. Aim: The aim of this review was to summarize and to reveal the effects of IMT in HF patients. Methods: Electronic searches were performed using Pubmed Database, Physiotherapy Evidence Database (PEDro) and Cochrane Library. Inclusion criteria were: RCTs, patients with HF, full text articles after 2010 and at least one intervention group with IMT. Methodological quality was assessed using the PEDro (Physiotherapy Evidence Database) scale. Results: Nineteen articles met the inclusion criteria and were included in this review. In most studies training protocols involved 3 to 7 sessions per week with intensity ≤30-60% of maximal inspiratory pressure (MIP), for a total duration of 4-12 weeks. Respiratory muscle strength improved in 11/12 studies, peripheral muscle strength in 4/5 studies, exercise capacity (peak VO2, VE/VCO2 slope) in 4/10, pulmonary function (FEV1, FEV1/FVC, FVC) in 0/5, functional capacity (6MWT) in 6/8, echocardiography parameters in 1/6, quality of life and dyspnea in 9/16. Control groups followed sham IMT, usual care, no intervention, intervention without exercise, or aerobic training, which could explain in some cases the conflicting results. Conclusions: IMT is beneficial for HF patients and should be included as a complementary method in cardiac rehabilitation programs. The optimal characteristics of ΙΜΤ as well as the benefits when combined with common forms of exercise need further research.

show abstract

Respiratory drive and breathing pattern abnormalities are related to exercise intolerance in chronic heart failure patients

Cited by 7 publications

References 27 publications

Improved Ventilatory Efficiency with Locomotor Muscle Afferent Inhibition is Strongly Associated with Leg Composition in Heart Failure

Improved Ventilatory Efficiency with Locomotor Muscle Afferent Inhibition is Strongly Associated with Leg Composition in Heart Failure

The acute effect of respiratory muscle training on microcirculation in patients with chronic heart failure

The Benefits of Inspiratory Muscle Training in Heart Failure Patients – A Systematic Review

Contact Info

Product

Resources

About