Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance.

European Journal of Applied Physiology
Taisuke NakadeShigeru Oshima

Abstract

Cardiopulmonary exercise testing (CPX) is used to evaluate functional capacity and assess prognosis in cardiac patients. Ventilatory efficiency (VE/VCO2) reflects ventilation-perfusion mismatch; the minimum VE/VCO2 value (minVE/VCO2) is representative of pulmonary arterial blood flow in individuals without pulmonary disease. Usually, minVE/VCO2 has a strong relationship with the peak oxygen uptake (VO2), but dissociation can occur. Therefore, we investigated the relationship between minVE/VCO2 and predicted peak VO2 (peak VO2%) and evaluated the parameters associated with a discrepancy between these two parameters. A total of 289 Japanese patients underwent CPX using a cycle ergometer with ramp protocols between 2013 and 2014. Among these, 174 patients with a peak VO2% lower than 70% were enrolled. Patients were divided into groups based on their minVE/VCO2 [Low group: minVE/VCO2 < mean - SD (38.8-5.6); High group: minVE/VCO2 > mean + SD (38.8 + 5.6)]. The characteristics and cardiac function at rest, evaluated using echocardiography, were compared between groups. The High group had a significantly lower ejection fraction, stroke volume, and cardiac output, and higher brain natriuretic peptide, tricuspid regurgitation pressure ...Continue Reading

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