Ventilatory response to exercise and kinetics of oxygen recovery are similar in cardiac transplant recipients and patients with mild chronic heart failure
| Autor: | Elias Tsolakis, S. T. Toumanidis, Ourania Papazachou, Christos Charitos, Christos Kassiotis, Serafim Nanas, Eleftheria P. Tsagalou, Zafiria J Margari, John Terrovitis, John N. Nanas |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment Hemodynamics Physical exercise Exercise intolerance Oxygen Consumption Internal medicine medicine Humans Exercise physiology Exercise Heart Failure Heart transplantation Transplantation Exercise Tolerance Pulmonary Gas Exchange business.industry Middle Aged medicine.disease Surgery Oxygen Case-Control Studies Heart failure Exercise Test Cardiology Heart Transplantation Female medicine.symptom Pulmonary Ventilation Cardiology and Cardiovascular Medicine business Anaerobic exercise |
| Zdroj: | The Journal of Heart and Lung Transplantation. 23:1154-1159 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2003.08.029 |
| Popis: | Exercise capacity, assessed by cardiopulmonary exercise treadmill testing (CPET), does not return to normal following heart transplantation. This study evaluated the ventilatory response to exercise and the kinetics of oxygen (O(2)) recovery in heart transplant recipients (HTR) compared to healthy volunteers (HV) and heart failure patients.Eighteen patients with end-stage heart failure (ESHF), 12 with mild heart failure (MHF) matched for peak oxygen consumption (Vo(2)) with the HTR, 12 HTR and 12 HV underwent CPET for measurements of peak Vo(2), Vo(2) at anaerobic threshold (AT), first-degree slope of Vo(2) decline during early recovery (Vo(2)/t-slope), time required for a 50% fall from peak Vo(2) (T(1/2) of Vo(2)) and the slopes of VE/Vco(2) and VE/Vo(2).The MHF and HTR groups had similar ventilatory responses to exercise and O(2) recovery kinetics. Peak Vo(2) (18.5 +/- 5.7 vs 9.4 +/- 0.9 ml/kg/min, p0.001), AT (13.8 +/- 4.8 vs 6.7 +/- 1.8 ml/kg/min, p0.001) and Vo(2)/t-slope (0.6 +/- 0.2 vs 0.3 +/- 0.2 liter/min/min, p = 0.055) were higher in the HTR than in the ESHF group. In contrast, HTR had lower VE/Vco(2)-slope (31.4 +/- 3.8 vs 39.2 +/- 9.9, p = 0.015) and T(1/2) Vo(2) (1.5 +/- 0.3 vs 2.4 +/- 1.1 minute, p = 0.014) than the ESHF group. Compared to HV, HTR had lower Vo(2) peak (18.5 +/- 5.7 vs 28.4 +/- 6.9 ml/kg/min, p0.001), AT (13.8 +/- 4.8 vs 19.8 +/- 4.5 ml/kg/min, p = 0.04), Vo(2)/t-slope (0.6 +/- 0.2 vs 1.0 +/- 0.4 liter/min/min, p = 0.005) and steeper VE/Vco(2) slope (31.4 +/- 3.8 vs 23.6 +/- 2.7, p = 0.062). Heart rate deceleration during recovery was significantly slower in HTR than in all other groups.Exercise intolerance and delayed O(2) recovery kinetics were only partially reversed after heart transplantation. This finding suggests that some of the pathophysiologic mechanisms of heart failure persist after heart transplantation. |
| Databáze: | OpenAIRE |
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