Mechanisms of periodic breathing during exercise in patients with chronic heart failure

Chest
Piergiuseppe AgostoniRichard K Albert

Abstract

Periodic breathing (PB) in heart failure (HF) is attributed to many factors, including low cardiac output delaying the time it takes pulmonary venous blood to reach the central and peripheral chemoreceptors, low lung volume, lung congestion, augmented chemoreceptor sensitivity, and the narrow difference between eupneic carbon dioxide tension and apneic/hypoventilatory threshold. We measured expired gases, ventilation, amplitude, and duration of PB in 23 patients with PB during progressive exercise tests done with 0 mL, 250 mL, or 500 mL of added dead space. Periodicity of PB remained constant despite heart rate, oxygen consumption, and minute ventilation increasing. Within each PB cycle, starting from the beginning of exercise, the largest (peak) tidal volume approached maximum observed tidal volume, while the smallest (nadir) tidal volume increased as exercise power output increased. PB ceased when nadir tidal volume reached peak tidal volume. End-tidal carbon dioxide increased with added dead space, and PB ceased progressively earlier during the exercise done with increased dead space. Circulatory delay does not contribute to the PB observed in exercising HF patients. The pattern of gradually increasing nadir tidal volume dur...Continue Reading

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Citations

Feb 1, 2013·Pulmonary Medicine·Anna ApostoloPiergiuseppe Agostoni
Apr 23, 2014·Journal of Cardiovascular Medicine·Piergiuseppe AgostoniErminio Sisillo
Oct 16, 2012·Trends in Cardiovascular Medicine·Bishnu P DhakalGregory D Lewis
Jan 26, 2010·Respiratory Physiology & Neurobiology·Carine C CallegaroJorge P Ribeiro
Dec 21, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R NeviereS Dharancy
Nov 28, 2012·International Journal of Cardiology·Jong-Shyan Wang
Jul 11, 2014·Journal of Cardiac Failure·Piergiuseppe AgostoniStefania Farina
Oct 25, 2016·International Journal of Cardiology·Alcides RochaJ Alberto Neder
May 15, 2009·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Alessandro MezzaniLuc Vanhees
Sep 18, 2008·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Jean-Paul SchmidPiergiuseppe Agostoni
Apr 27, 2017·Annals of the American Thoracic Society·Piergiuseppe AgostoniMichele Emdin
Jun 26, 2015·Physiological Reports·Eric HermandJean-Paul Richalet
Mar 10, 2017·The European Respiratory Journal·J Alberto NederDenis E O'Donnell
Nov 27, 2020·European Journal of Preventive Cardiology·Piergiuseppe AgostoniGianfranco Sinagra
Sep 17, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·J Alberto NederDenis E O'Donnell
Mar 25, 2020·Journal of Cardiac Failure·Ivan CundrleLyle J Olson

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