Resting lung function and hemodynamic parameters as predictors of exercise capacity in patients with chronic heart failure.
OBJECTIVE
The aim of this study was to examine the role of resting pulmonary function and hemodynamic parameters as predictors of exercise capacity in patients with chronic heart failure.


RESULTS
Fifty-one patients with chronic heart failure underwent resting pulmonary function testing, including inspiratory capacity (IC) and symptom-limited, treadmill cardiopulmonary exercise testing (CPET). Right-heart catheterization and radionuclide ventriculography were performed within 2 days of CPET. Mean (+/- SD) left ventricular ejection fraction was 31 +/- 12% and cardiac index was 2.34 +/- 0.77 L/min/m(2). Percentage of predicted FEV(1) was 92 +/- 14%, percentage of predicted FVC was 94 +/- 15%, FEV(1)/FVC was 81 +/- 4%, and percentage of predicted IC was 84 +/- 18%. Mean peak oxygen uptake (peak O(2)) was 17.9 +/- 5.4 mL/kg/min. Analysis of variance among the three functional Weber classes showed statistically significant differences for pulmonary capillary wedge pressure (PCWP) and IC. Specifically, the more severe the exercise intolerance, the lower was IC and the higher was PCWP. In a multivariate stepwise regression analysis, using peak O(2) (liters per minute) as the dependent variable and the pulmonary function test measurements as independent variables, the only significant predictor selected was IC (r = 0.71, p < 0.0001). In a final stepwise regression analysis including all the independent variables of the resting pulmonary function tests and hemodynamic measurements, the two predictors selected were IC and PCWP (r(2) = 0.58).


CONCLUSIONS
In patients with chronic heart failure, IC is inversely related to PCWP and is a strong independent predictor of functional capacity.
Pulmonary and Critical Care Medicine Department, National and Kapodestrian University, Montreal, Canada. snanas@cc.uoa.gr
Serafim
S
Nanas
John
J
Nanas
Ourania
O
Papazachou
Christos
C
Kassiotis
Antonios
A
Papamichalopoulos
Joseph
J
Milic-Emili
Charis
C
Roussos
D002302:Cardiac Output; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006333:Heart Failure / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010101:Oxygen Consumption; D010366:Peak Expiratory Flow Rate; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure; D012044:Regression Analysis; D015656:Respiratory Mechanics; D013318:Stroke Volume; D016277:Ventricular Function, Left; D014797:Vital Capacity