title: Dynamic pulmonary hyperinflation occurs without expiratory flow limitation in chronic heart failure during exercise.
abstract: To assess the occurrence of tidal expiratory flow limitation (EFL) and/or dynamic pulmonary hyperinflation (DH) in chronic heart failure (CHF) during exercise 15 patients with stable systolic CHF, aged 69 ± 6yr, underwent pulmonary function testing and incremental cardio-pulmonary exercise testing. They subsequently performed constant load exercise testing at 30, 60 and 90% of respective maximum workload. At each step the presence of EFL, by negative expiratory pressure technique, and changes in inspiratory capacity (IC) were assessed. Ejection fraction amounted to 36 ± 6% and VO₂, peak (77 ± 19% pred.) was reduced. EFL was absent at any step during constant load exercise. In 6 patients IC decreased more than 10% pred. at highest step. Only in these patients TLC, FRC, RV FEF(25-75%) and DL(CO) were decreased at rest. VO₂, peak correlated with DL(CO), TLC and IC at rest and with IC (r(2)=0.59; p<0.001) and decrease in IC (r(2)=0.44; p<0.001) at 90% of maximum workload. During exercise CHF patients do not exhibit EFL, but some of them develop DH that is associated with lower VO₂, peak.
authors.affiliation: Respiratory Medicine Unit, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Chiari
authors.forename: Chiara
authors.initials: C
authors.lastname: Torregiani
authors.forename: Enrico
authors.initials: E
authors.lastname: Boni
authors.forename: Sonia
authors.initials: S
authors.lastname: Bassini
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Claudio
authors.initials: C
authors.lastname: Tantucci
mesh_terms: D000368:Aged; D015444:Exercise / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology*; D008168:Lung / Q000503:physiopathology*; D008297:Male
keywords: Chronic heart failure; Exercise; Expiratory flow limitation; Inspiratory capacity; Negative expiratory pressure; Pulmonary hyperinflation