help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by O'DONNELL, D. E.
Right arrow Articles by WEBB, K. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by O'DONNELL, D. E.
Right arrow Articles by WEBB, K. A.

Am. J. Respir. Crit. Care Med., Volume 160, Number 6, December 1999, 1804-1811

Ventilatory Assistance Improves Exercise Endurance in Stable Congestive Heart Failure

DENIS E. O'DONNELL, CHRISTINE D'ARSIGNY, SATISH RAJ, HOSHIAR ABDOLLAH, and KATHERINE A. WEBB

Respiratory Investigation Unit, Department of Medicine, Queen's University, Kingston, Ontario, Canada

We postulated that ventilatory assistance during exercise would improve cardiopulmonary function, relieve exertional symptoms, and increase exercise endurance (Tlim) in patients with chronic congestive heart failure (CHF). After baseline pulmonary function tests, 12 stable patients with advanced CHF (ejection fraction, 24 ± 3% [mean ± SEM]) performed constant-load exercise tests at approximately 60% of their predicted maximal oxygen consumption (V O2max) while breathing each of control (1 cm H2O), continuous positive airway pressure optimized to the maximal tolerable level (CPAP = 4.8 ± 0.2 cm H2O) or inspiratory pressure support (PS = 4.8 ± 0.2 cm H2O), in randomized order. Measurements during exercise included cardioventilatory responses, esophageal pressure (Pes), and Borg ratings of dyspnea and leg discomfort (LD). At a standardized time near end-exercise, PS and CPAP reduced the work of breathing per minute by 39 ± 8 and 25 ± 4%, respectively (p < 0.01). In response to PS: Tlim increased by 2.8 ± 0.8 min or 43 ± 14% (p < 0.01); slopes of LD-time, V O2-time, V CO2-time, and tidal Pes-time decreased by 24 ± 10, 20 ± 11, 28 ± 8, and 44 ± 9%, respectively (p < 0.05); dyspnea and other cardioventilatory parameters did not change. CPAP did not significantly alter measured exercise responses. The increase in Tlim was explained primarily by the decrease in LD- time slopes (r = -0.71, p < 0.001) which, in turn, correlated with the reductions in V O2-time (r = 0.61, p < 0.01) and tidal Pes-time (r = 0.52, p < 0.01). in conclusion, ventilatory muscle unloading with PS reduced exertional leg discomfort and increased exercise endurance in patients with stable advanced CHF. O'Donnell DE, D'Arsigny C, Raj S, Abdollah H, Webb KA. Ventilatory assistance improves exercise endurance in stable congestive heart failure.




This article has been cited by other articles:


Home page
 J. Appl. Physiol.Home page
J. L. Smith, J. E. Butler, P. G. Martin, R. A. McBain, and J. L. Taylor
Increased ventilation does not impair maximal voluntary contractions of the elbow flexors
J Appl Physiol, June 1, 2008; 104(6): 1674 - 1682.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
A. Borghi-Silva, C. Carrascosa, C. C. Oliveira, A. C. Barroco, D. C. Berton, D. Vilaca, E. B. Lira-Filho, D. Ribeiro, L. E. Nery, and J. A. Neder
Effects of respiratory muscle unloading on leg muscle oxygenation and blood volume during high-intensity exercise in chronic heart failure
Am J Physiol Heart Circ Physiol, June 1, 2008; 294(6): H2465 - H2472.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
L. M. Romer and M. I. Polkey
Exercise-induced respiratory muscle fatigue: implications for performance
J Appl Physiol, March 1, 2008; 104(3): 879 - 888.
[Abstract] [Full Text] [PDF]

Home page
 J. Physiol.Home page
J. D. Witt, J. A. Guenette, J. L. Rupert, D. C. McKenzie, and A. W. Sheel
Inspiratory muscle training attenuates the human respiratory muscle metaboreflex
J. Physiol., November 1, 2007; 584(3): 1019 - 1028.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
J. D. Miller, C. A. Smith, S. J. Hemauer, and J. A. Dempsey
The effects of inspiratory intrathoracic pressure production on the cardiovascular response to submaximal exercise in health and chronic heart failure
Am J Physiol Heart Circ Physiol, January 1, 2007; 292(1): H580 - H592.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
V. L. Wittmer, G. M. S. Simoes, L. C. M. Sogame, and E. C. Vasquez
Effects of continuous positive airway pressure on pulmonary function and exercise tolerance in patients with congestive heart failure.
Chest, July 1, 2006; 130(1): 157 - 163.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. D. Miller, S. J. Hemauer, C. A. Smith, M. K. Stickland, and J. A. Dempsey
Expiratory threshold loading impairs cardiovascular function in health and chronic heart failure during submaximal exercise
J Appl Physiol, July 1, 2006; 101(1): 213 - 227.
[Abstract] [Full Text] [PDF]

Home page
 J. Physiol.Home page
L. M. Romer, A. T. Lovering, H. C. Haverkamp, D. F. Pegelow, and J. A. Dempsey
Effect of inspiratory muscle work on peripheral fatigue of locomotor muscles in healthy humans
J. Physiol., March 1, 2006; 571(2): 425 - 439.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. D. Miller, D. F. Pegelow, A. J. Jacques, and J. A. Dempsey
Effects of augmented respiratory muscle pressure production on locomotor limb venous return during calf contraction exercise
J Appl Physiol, November 1, 2005; 99(5): 1802 - 1815.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. Troosters, R. Casaburi, R. Gosselink, and M. Decramer
Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 19 - 38.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
G. Scano, L. Stendardi, and M. Grazzini
Understanding dyspnoea by its language
Eur. Respir. J., February 1, 2005; 25(2): 380 - 385.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
D.E. O'Donnell, N. Voduc, M. Fitzpatrick, and K.A. Webb
Effect of salmeterol on the ventilatory response to exercise in chronic obstructive pulmonary disease
Eur. Respir. J., July 1, 2004; 24(1): 86 - 94.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. van 't Hul, R. Gosselink, P. Hollander, P. Postmus, and G. Kwakkel
Acute effects of inspiratory pressure support during exercise in patients with COPD
Eur. Respir. J., January 1, 2004; 23(1): 34 - 40.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. R. Rodman, K. S. Henderson, C. A. Smith, and J. A. Dempsey
Cardiovascular effects of the respiratory muscle metaboreflexes in dogs: rest and exercise
J Appl Physiol, September 1, 2003; 95(3): 1159 - 1169.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Laghi and M. J. Tobin
Disorders of the Respiratory Muscles
Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
K K A Witte, S D R Thackray, N P Nikitin, J G F Cleland, and A L Clark
Pattern of ventilation during exercise in chronic heart failure
Heart, June 1, 2003; 89(6): 610 - 614.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
T.J. Kufel, L.A. Pineda, R.G. Junega, R. Hathwar, and M.J. Mador
Diaphragmatic function after intense exercise in congestive heart failure patients
Eur. Respir. J., December 1, 2002; 20(6): 1399 - 1405.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
P G Agostoni, M Bussotti, P Palermo, and M Guazzi
Does lung diffusion impairment affect exercise capacity in patients with heart failure?
Heart, December 1, 2002; 88(5): 453 - 459.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. D. HUGHES, N. HART, C.-H. HAMNEGÅRD, M. GREEN, A. J. S. COATS, J. MOXHAM, and M. I. POLKEY
Inspiratory Muscle Relaxation Rate Slows during Exhaustive Treadmill Walking in Patients with Chronic Heart Failure
Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1400 - 1403.
[Abstract] [Full Text]

Home page
 J. Appl. Physiol.Home page
C. A. Harms, T. J. Wetter, C. M. St. Croix, D. F. Pegelow, and J. A. Dempsey
Effects of respiratory muscle work on exercise performance
J Appl Physiol, July 1, 2000; 89(1): 131 - 138.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Y. Sue
Exertional Dyspnea in Congestive Heart Failure : Living Longer and Doing More?
Chest, July 1, 2000; 118(1): 5 - 7.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1999 American Thoracic Society