RT Journal Article
SR Electronic
T1 Minute ventilation/carbon dioxide production in chronic heart failure
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 200141
DO 10.1183/16000617.0141-2020
VO 30
IS 159
A1 Piergiuseppe Agostoni
A1 Susanna Sciomer
A1 Pietro Palermo
A1 Mauro Contini
A1 Beatrice Pezzuto
A1 Stefania Farina
A1 Alessandra Magini
A1 Fabiana De Martino
A1 Damiano Magrì
A1 Stefania Paolillo
A1 Gaia Cattadori
A1 Carlo Vignati
A1 Massimo Mapelli
A1 Anna Apostolo
A1 Elisabetta Salvioni
YR 2021
UL http://err.ersjournals.com/content/30/159/200141.abstract
AB 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