title: Cardiopulmonary interaction in heart failure.
abstract: In heart failure lung dysfunction is frequent and is greater the greater the heart failure severity. It can be evaluated in terms of lung mechanics and gas diffusion. Indeed heart-lung interaction is related to heart dimensions and lung fluid content; furthermore heart-lung interaction is influenced by the body position. Lung diffusion is also altered in patients with chronic heart failure, and a low gas diffusion is associated with a reduced performance. During exercise, heart-lung interaction becomes more evident. Heart failure patients show an abnormal hyperventilation due to a progressively increased respiratory rate, and a lower tidal volume; hyperventilation is due to different causes including enhanced responses from chemo- and metabolo-receptors, increased CO(2) production and increased dead space ventilation. Several drugs affect the ventilatory pattern in heart failure patients: ACE-inhibitors and anti-aldosteronic drugs improve lung diffusion and ventilatory efficiency during exercise; beta-blockers reduce exercise-induced hyperventilation. Furthermore, ultrafiltration improves lung mechanics, both at rest and during exercise, through body fluid content reduction.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, via Parea 4, 20138 Milan, Italy. piergiuseppe.agostoni@CCFM.it
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
authors.forename: Gaia
authors.initials: G
authors.lastname: Cattadori
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bussotti
authors.forename: Anna
authors.initials: A
authors.lastname: Apostolo
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015444:Exercise / Q000502:physiology; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D011659:Pulmonary Gas Exchange; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists