2016


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2016/№4

Prognostic value of lung ventilation effectiveness in chronic heart failure patients with dilated cardiomyopathy

Kamenskaya O.V., Loginova I.Yu., Doronin D.V., Chernyavsky A.M.
Federal State Budgetary Institution, "Academician E.N. Meshalkin Novosibirsk Research Institute of Circulatory Pathology " of the RF Ministry of Health Care, Rechkunovskaya 15, Novosibirsk 630055

Keywords: dilated cardiomyopathy, cardiorespiratory test, pulmonary ventilation, CHF

DOI: 10.18087/rhfj.2016.4.2226

Background. According to guidelines determination of indications for heart transplantation includes the cardiopulmonary stress test. Peak oxygen consumption (VO2) is most commonly used for evaluation of disease prognosis and risks of surgical intervention. The major limitation of using peak VO2 is a need to achieve the anaerobic threshold during exercise, which is not always feasible in patients with pronounced CHF. For this reason, other parameters of pulmonary ventilation and gas exchange have been recently considered as predictive markers. Aim. To evaluate the prognostic value of pulmonary ventilation parameters in patients with dilated cardiomyopathy (DCMP) and pronounced CHF. Materials and methods.Results of the cardiopulmonary stress test were retrospectively analyzed for 36 patients with DCMP and FC III-IV CHF included in the waiting list for heart transplantation. Results. The cardiopulmonary stress test showed low exercise tolerance in patients with pronounced CHF associated with DCMP. Mean exercise time was 8 (6-9)min; the performed specific work was 18 (11-26) kGm/kg; and the threshold load power was 60 (40-60) W. The anaerobic threshold was reached in 32 (89%) patients. The peak oxygen consumption (VO2) was 10.4 (9.8–12.2) ml/min/kg. Exercise tolerance statistically significantly correlated with parameters of pulmonary ventilation efficiency (EQO2 and EQCO2) at rest (r=–0.66 and r=–0.71, respectively, p<0.05), peak VO2 (r=0.53, p<0.05), and EQCO2 (r=–0.52, p<0.05) at the level of threshold load power. According to results of the regression analysis, a high level of resting EQO2 and EQCO2 was the most significant predictor for low exercise tolerance. Conclusion. Parameters of pulmonary ventilation efficiency measured at rest possess a prognostic significance for exercise tolerance, which is particularly important for patients intolerant to submaximal exercise.
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Kamenskaya O.V., Loginova I.Yu., Doronin D.V., Chernyavsky A.M. Prognostic value of lung ventilation effectiveness in chronic heart failure patients with dilated cardiomyopathy. Russian Heart Failure Journal. 2016;17 (4):273–277

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