Chest
Cardiology: Clinical InvestigationsDynamics of Oxygen Uptake for Submaximal Exercise and Recovery in Patients With Chronic Heart Failure
Section snippets
Subjects
Patients were selected on the basis of having a clinical history of CHF, and a resting left ventricular ejection fraction of 40 percent or less. All were judged to be clinically stable and compensated on medical therapy at the time of study. None was taking adrenergic antagonists or other medications known to affect the dynamic responses measured, and none had exertional angina or conditions contraindicating exercise. Ten male subjects who served as control subjects were selected on the basis
RESULTS
Patient characteristics are summarized in Table 1. Etiology of heart failure was idiopathic in eight, ischemic in seven, hypertensive in two, and rheumatic in one. No patient had significant valvular stenosis. Their left ventricular ejection fractions measured at rest averaged 26±7 percent. The patients’ peak values averaged 1,380±399 ml/min (18.2±6 ml/min/kg), which represented 65±18 percent of their age- and size-based predicted values.14 The LAT was apparent from analysis of gas
DISCUSSION
In 1923, Hill and Lupton16 introduced the concept that persistent elevation of following cessation of exercise represented the repaying of an “O2 debt,” incurred because of the delay in attainment of the steady-state requirements of the work in the early minutes of exercise. The O2 debt is thus similar, though not necessarily identical,17 to the corresponding O2 deficit at exercise onset. The deficit may be attributed to: (1) a circulatory delay between the consumption of O2
ACKNOWLEDGMENTS
The authors gratefully acknowledge the assistance of Medical Graphics Corporation for technical support and development of the data analysis software.
REFERENCES (28)
- et al.
Total cardiac output response during four minutes of exercise
Am Heart J
(1968) - et al.
Oscillatory hyperventilation in severe congestive heart failure secondary to idiopathic dilated cardiomyopathy or ischemic cardiomyopathy
Am J Cardiol
(1987) - et al.
Relation of oxygen uptake to work rate in normal men and men with circulatory disorders
Am J Cardiol
(1987) - et al.
Response of oxygen uptake to exercise in coronary artery disease
Chest
(1974) - et al.
Oxygen consumption, oxygen debt and lactic acid in circulatory failure
J Clin Invest
(1927) - et al.
Faster adjustment to and recovery from submaximal exercise in the trained state
J Appl Physiol
(1980) Dynamics of pulmonary gas exchange and heart rate changes at start and end of exercise
Acta Physiol Scand suppl
(1974)- et al.
Dynamics of pulmonary gas exchange during exercise
- et al.
Parameters of ventilatory and gas exchange dynamics during exercise
J Appl Physiol
(1982) - et al.
Oxygen utilization and ventilation during exercise in patients with chronic cardiac failure
Circulation
(1982)
Exercise training in patients with severe left ventricular dysfunction: hemodynamic and metabolic effects
Circulation
A respiratory gas exchange simulator for routine calibration in metabolic studies
Eur Respir J
A new method for detecting anaerobic threshold by gas exchange
J Appl Physiol
The analysis of repeated measures designs involving multiple dependent variables
Res Quart Exer Sport
Cited by (148)
Lean Mass Abnormalities in Heart Failure: The Role of Sarcopenia, Sarcopenic Obesity, and Cachexia
2020, Current Problems in CardiologyMetabolic Transitions and Muscle Metabolic Stability: Effects of Exercise Training
2018, Muscle and Exercise PhysiologyPost-Exercise Oxygen Uptake Recovery Delay: A Novel Index of Impaired Cardiac Reserve Capacity in Heart Failure
2018, JACC: Heart FailureCitation Excerpt :Notably, the patients studied by Nanas et al. (16) included individuals with NYHA functional class I and average peak VO2 was higher than in our study population (16.7 ml/kg/min vs. 13.3 ml/kg/min), hence it is to be expected that recovery kinetics were more rapid in the Nanas study compared with this study. Our findings relating VO2RD to impaired exercise CO augmentation and poor prognosis are also consistent with those of other investigators who have linked measures of impaired VO2 recovery kinetics to functional capacity and prognosis in patients with dilated cardiomyopathy (17) and HFrEF (7,23–25). For example, Tanabe et al. (18) described a strong correlation between T1/2 and cardiac index at peak exercise in HFrEF.
Noninvasive Ventilation Before Maximum Exercise Test Increases Exercise Tolerance in Subjects With Heart Failure: A Crossover Study
2017, Archives of Physical Medicine and RehabilitationEvaluation of Cardiac, Vascular, and Skeletal Muscle Function With MRI: Novel Physiological End Points in Cardiac Rehabilitation Research
2016, Canadian Journal of CardiologyA Systematic Approach for the Interpretation of Cardiopulmonary Exercise Testing in Children with Focus on Cardiovascular Diseases
2023, Journal of Cardiovascular Development and Disease
Supported in part by NIH grants HL11907 and HL01642 and the Ciba-Giegy Corporation.