title: Noninvasive assessment of cardiac function during exercise in patients with CHF or COPD: measurement of aortic bloodflow indices by continuous wave Doppler.
abstract: OBJECTIVE
  To test whether continuous-wave Doppler measurements of aortic bloodflow indices would reliably distinguish patients with congestive heart failure (CHF) from those with chronic obstructive pulmonary disease (COPD) and a similar degree of exertional dyspnea. DESIGN. Parallel group comparison.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Eighteen out-patients with clinically distinct syndromes of CHF or COPD but of similar age and functional limitation.
  
  
  METHODS
  Participants were observed during graded treadmill exercise. The following indices were obtained: heart rate, systolic blood pressure (SBP), earlobe oxygen saturation, and continuous-wave Doppler measurements of aortic bloodflow from the suprasternal notch.
  
  
  RESULTS
  Exercise duration (mean +/- SE): COPD 14.2 +/- 1.2 mins, CHF 14.0 +/- 1.2 mins, not significant. Maximum results during exercise: heart rate, CHF 143 +/- 7 beats/min, COPD 149 +/- 5 beats/min, not significant; peak velocity, CHF 0.60 +/- 0.04 m/s, COPD 0.92 +/- 0.07 m/s, P < 0.005; peak acceleration, CHF 17 +/- 1 m/s2, COPD 37 +/- 3 m/s2, P < 0.001; SBP: CHF 152 +/- 8 mmHg, COPD 207 +/- 5 mmHg, P < 0.001; minimum oxygen saturation: CHF 92 +/- 1%, COPD 88 +/- 2%, not significant.
  
  
  CONCLUSIONS
  Aortic bloodflow indices can be measured during exercise in patients with exertional dyspnea due to CHF or COPD and, in CHF, these indices are significantly reduced compared with individuals with COPD measured at similar levels of exercise. These data suggest that measurement of aortic bloodflow indices may have a role as an adjunct to routine tests in the diagnosis of patients with dyspnea. Further studies are indicated in patients with clinical features of both COPD and CHF in whom the etiology of dyspnea is uncertain.
authors.affiliation: Department of Medicine, Victoria Hospital, London, Ontario.
authors.forename: J E
authors.initials: JE
authors.lastname: Hux
authors.forename: D G
authors.initials: DG
authors.lastname: McCormack
authors.forename: J M
authors.initials: JM
authors.lastname: Arnold
mesh_terms: D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology*; D015150:Echocardiography, Doppler / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D015203:Reproducibility of Results