title: Central Chemoreceptor Sensitivity Is Not Enhanced in Contemporary Patients With Chronic Systolic Heart Failure Receiving Optimal Treatment.
abstract: BACKGROUND
  Clinical and prognostic consequences of enhanced central chemosensitivity in the contemporary optimally treated patients with chronic heart failure (CHF) are unknown.
  
  
  RESULTS
  We studied central chemosensitivity (defined as hypercapnic ventilatory response [HCVR; L/min/mmHg]) in 161 CHF patients (mean left ventricular ejection fraction [LVEF] 31 ± 6%, all receiving a combination of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker) and 55 sex- and age-matched healthy controls. HCVR did not differ between CHF patients and controls (median 0.63 vs 0.57 L/min-1/mmHg-1, P = .76). When the CHF patients were divided into tertiles according to their HCVR values, there were no significant differences in clinical characteristics (except for ischemic etiology, which was more frequent in those with the highest HCVR), results of the cardiopulmonary exercise testing, and indices of heart rate variability. During the follow-up (median 28 months, range 1-48 months, ≥15 months in all survivors), 21 patients died. HCVR was not related to survival in the Cox proportional hazards analysis.
  
  
  CONCLUSIONS
  Central chemosensitivity is not enhanced in contemporary, optimally treated CHF patients and its assessment does not provide significant clinical or prognostic information.
authors.affiliation: Department of Physiology, Wroclaw Medical University, Wroclaw, Poland; Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland. Electronic address: bartlomiej.paleczny@gmail.com.
authors.forename: Bartłomiej
authors.initials: B
authors.lastname: Paleczny
authors.affiliation: Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Martyna
authors.initials: M
authors.lastname: Olesińska
authors.affiliation: Department of Physiology, Wroclaw Medical University, Wroclaw, Poland; Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Siennicka
authors.affiliation: Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Niewiński
authors.affiliation: Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland; Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Ewa A
authors.initials: EA
authors.lastname: Jankowska
authors.affiliation: Department of Physiology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Ponikowska
authors.affiliation: Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Banasiak
authors.affiliation: Division of Innovative Clinical Trials, Department of Cardiology & Pulmonology, University Medicine Göttingen (UMG), Göttingen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Von Haehling
authors.affiliation: Division of Innovative Clinical Trials, Department of Cardiology & Pulmonology, University Medicine Göttingen (UMG), Göttingen, Germany.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002628:Chemoreceptor Cells / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: Central chemoreflex; heart failure; hypercapnic ventilatory response