TY - JOUR T1 - Minute ventilation/carbon dioxide production in chronic heart failure JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0141-2020 VL - 30 IS - 159 SP - 200141 AU - Piergiuseppe Agostoni AU - Susanna Sciomer AU - Pietro Palermo AU - Mauro Contini AU - Beatrice Pezzuto AU - Stefania Farina AU - Alessandra Magini AU - Fabiana De Martino AU - Damiano Magrì AU - Stefania Paolillo AU - Gaia Cattadori AU - Carlo Vignati AU - Massimo Mapelli AU - Anna Apostolo AU - Elisabetta Salvioni Y1 - 2021/03/31 UR - http://err.ersjournals.com/content/30/159/200141.abstract N2 - In chronic heart failure, minute ventilation (V′E) for a given carbon dioxide production (V′CO2) might be abnormally high during exercise due to increased dead space ventilation, lung stiffness, chemo- and metaboreflex sensitivity, early metabolic acidosis and abnormal pulmonary haemodynamics. The V′E versus V′CO2 relationship, analysed either as ratio or as slope, enables us to evaluate the causes and entity of the V′E/perfusion mismatch. Moreover, the V′E axis intercept, i.e. when V′CO2 is extrapolated to 0, embeds information on exercise-induced dead space changes, while the analysis of end-tidal and arterial CO2 pressures provides knowledge about reflex activities. The V′E versus V′CO2 relationship has a relevant prognostic power either alone or, better, when included within prognostic scores. The V′E versus V′CO2 slope is reported as an absolute number with a recognised cut-off prognostic value of 35, except for specific diseases such as hypertrophic cardiomyopathy and idiopathic cardiomyopathy, where a lower cut-off has been suggested. However, nowadays, it is more appropriate to report V′E versus V′CO2 slope as percentage of the predicted value, due to age and gender interferences. Relevant attention is needed in V′E versus V′CO2 analysis in the presence of heart failure comorbidities. Finally, V′E versus V′CO2 abnormalities are relevant targets for treatment in heart failure.In chronic heart failure, the V′E versus V′CO2 relationship gives information about V′E/perfusion mismatch and exercise-induced dead space changes, has a relevant prognostic power, and may be modified in the presence of comorbidities https://bit.ly/2NwZWHa ER -