title: Does exercise have deleterious consequences for the lungs of patients with chronic heart failure?
abstract: Changes in lung function in patients with chronic heart failure (CHF), usually reported at rest, may be exacerbated during exercise and induce post-exercise effects. We investigated the hypothesis that post-exercise induced changes in lung function in CHF patients are due to the consequences of left atrial overload. Twenty-one CHF patients and six healthy subjects (Ctrl) participated in this study. Transfer lung capacity for carbon monoxide (T(LCO)) and maximal expiratory flows (V (max)) were measured before a maximal exercise test and 1h, 2h and 20h afterwards. CHF patients were divided in two groups according to their ventilatory response to the maximal exercise test (V(E) vs. V(CO(2)) relationship slopes above or below 34, i.e., CHF>34 and CHF<34). Compared with the Ctrl group, in CHF groups resting T(LCO) and V(max) were lower. After exercise, further changes in T(LCO) and V(max) were observed in CHF>34. T(LCO) per unit volume (K(CO)) was increased 1h post-exercise while maximal expiratory flow between 25 and 75% of forced vital capacity was decreased 2h and 20h post-exercise. We observed a negative correlation between the delta T(LCO) 1h post-exercise from rest and the delta T(LCO) 2h post-exercise from rest. The decreases in pulmonary V(max) we observed well after exercise following increases in K(CO) in patients with high ventilatory response to exercise (CHF>34) might indicate bronchial congestion resulting from increased left atrial pressure during exercise. We propose that endurance training should be prescribed cautiously for these patients.
authors.affiliation: Laboratoire des Adaptations Physiologiques aux Activités Physiques, Faculté des Sciences du Sport, UPRES EA, Poitiers, France.
authors.forename: Manuel
authors.initials: M
authors.lastname: Roulaud
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.forename: Pascale
authors.initials: P
authors.lastname: Raud-Raynier
authors.forename: André
authors.initials: A
authors.lastname: Denjean
authors.forename: Claire
authors.initials: C
authors.lastname: de Bisschop
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002248:Carbon Monoxide / Q000378:metabolism; D016022:Case-Control Studies; D002908:Chronic Disease; D000075202:Contraindications; D005080:Exercise Test / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005541:Forced Expiratory Volume; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008448:Maximal Expiratory Flow Rate; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity; D014797:Vital Capacity
chemical_list: D002248:Carbon Monoxide