title: Exercise oscillatory ventilation in heart failure and in pulmonary arterial hypertension.
abstract: BACKGROUND
  Patients with pulmonary arterial hypertension (PAH) and with heart failure (HF) have increased ventilatory responses to exercise in proportion to disease severity. Exercise-associated oscillatory ventilation (EOV) predicts poor outcome in HF. Whether EOV occurs in PAH is unknown.
  
  
  METHODS
  We analyzed the initial cardiopulmonary exercise tests (CPETs) and right heart catheterization data of 109 patients with PAH and in 107 patients with HF consecutively referred to our center.
  
  
  RESULTS
  The PAH patients were aged 54±16 years and their NYHA functional class was 2.8±0.5. The HF patients were aged 53±13 years and NYHA 2.4±0.6. Hemodynamic data were obtained in only 36 of them. The patients with PAH compared to those with HF had a lower peak VO2 (13±5 vs 17±5 mL/kg/min, p<0.001) and a higher ventilatory equivalent for CO2 (VE/VCO2) slope (55±21 vs 34±7, p<0.001). Mean pulmonary artery pressure was higher (50±10 vs 29±11 mmHg) and wedge pressure lower (10±3 vs 19±5 mmHg) in PAH patients, but cardiac output was not different (4.0±1.3 vs 4.2±1.2L/min). EOV was present in 22 patients (21%) with HF and in no patient with PAH.
  
  
  CONCLUSIONS
  Patients with PAH compared to HF with slightly better functional class have a lower aerobic exercise capacity and higher ventilatory responses, but no EOV. An increase in pulmonary artery wedge pressure rather than a low cardiac output may be necessary condition of EOV in HF.
authors.affiliation: Erasme University Hospital, Department of Cardiology, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Marco
authors.initials: M
authors.lastname: Vicenzi
authors.affiliation: Erasme University Hospital, Department of Cardiology, Université Libre de Bruxelles, Bruxelles, Belgium; Faculty of Motor Sciences, Department of Physiology, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Gael
authors.initials: G
authors.lastname: Deboeck
authors.affiliation: Faculty of Motor Sciences, Department of Physiology, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Vitalie
authors.initials: V
authors.lastname: Faoro
authors.affiliation: Faculty of Motor Sciences, Department of Physiology, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Juliane
authors.initials: J
authors.lastname: Loison
authors.affiliation: Erasme University Hospital, Department of Cardiology, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Vachiery
authors.affiliation: Erasme University Hospital, Department of Cardiology, Université Libre de Bruxelles, Bruxelles, Belgium; Faculty of Motor Sciences, Department of Physiology, Université Libre de Bruxelles, Bruxelles, Belgium. Electronic address: rnaeije@ulb.ac.be.
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
mesh_terms: D006328:Cardiac Catheterization; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D012123:Pulmonary Ventilation / Q000502:physiology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012189:Retrospective Studies; D016278:Ventricular Function, Right / Q000502:physiology*
keywords: Cardiopulmonary exercise test; Chemosensitivity; Chronic heart failure; Exercise oscillatory ventilation; Oxygen uptake; Pulmonary hypertension