Airway resistance in chronic heart failure measured by impulse oscillometry.
BACKGROUND
Patients with chronic heart failure (CHF) complain of breathlessness and fatigue on exertion, have reduced peak oxygen consumption (pV(O(2))), and an increased ventilatory response to exercise (V(E)/V(CO(2)) slope). These limitations correlate with abnormalities of spirometry (forced expiratory volume in 1 second [FEV(1)] and forced ventilatory capacity [FVC]). Increased airway resistance by increasing the work of breathing might contribute to exercise intolerance in CHF.


METHODS
Impulse oscillometry (IOS) measures airway resistance and lung compliance independently of respiratory muscle strength and patient compliance. Sound waves of varying frequencies are sent into the lungs and the amplitude and phase shift of the reflected waves give a measure of airway resistance (R) and reactance (X). Twenty-three CHF patients and 18 controls underwent peak exercise testing with metabolic gas analysis and had airway resistance assessment using the Jaeger (Würtzberg, Germany) IOS system.


RESULTS
Patients had a lower pV(O(2)) (18.7 (4.0) v 39.2 (8.3) mL x kg x min; P < .0001), elevated V(E)/V(CO(2)) slope (41.6 (8.1) v 27.4 (2.9)), and lower FEV(1) (2.4 (0.4) v 3.2 (0.7) L/min; P = .0001) and FVC (3.3 (0.7) v 4.1 (1.1) L; P < .005) than controls. R and X correlated with spirometric abnormalities and were different between patients and controls (R at 5 Hz 0.44 (0.16) v 0.30 (0.15) kPa (L/s); P < .005 and X at 5 Hz -0.16 (0.08) v -0.09 (0.08) kPa (L/s); P < .05). R at 5 Hz correlated with pV(O(2)) (0.46; P = .0025) and V(E)/V(CO(2)) slope (0.43; P < .05).


CONCLUSIONS
CHF patients have elevated airway resistance and reduced reactance measured with IOS compared with control subjects.
Witte
Klaus K A
KK
Department of Academic Cardiology, Castle Hill Hospital, Cottingham, Hull, UK.
Morice
Alyn
A
Clark
Andrew L
AL
Cleland
John G F
JG
D000368:Aged; D000403:Airway Resistance / Q000187:drug effects / Q000502:physiology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000379:methods*; D011237:Predictive Value of Tests; D011659:Pulmonary Gas Exchange / Q000187:drug effects / Q000502:physiology; D011945:Receptors, Angiotensin / Q000627:therapeutic use; D012907:Smoking / Q000009:adverse effects; D013223:Statistics as Topic; D014797:Vital Capacity / Q000187:drug effects / Q000502:physiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D011945:Receptors, Angiotensin