PMID- 11243962
OWN - NLM
STAT- MEDLINE
DCOM- 20010419
LR  - 20190514
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 119
IP  - 3
DP  - 2001 Mar
TI  - Significance of end-tidal P(CO(2)) response to exercise and its relation to 
      functional capacity in patients with chronic heart failure.
PG  - 811-7
AB  - OBJECTIVES: The value of end-tidal PCO(2) monitoring during exercise in patients 
      with chronic heart failure has not been elucidated. The present study was 
      designed to examine end-tidal PCO(2) response to exercise and its relation to 
      functional capacity in patients with chronic heart failure. METHODS AND RESULTS: 
      Maximal upright ergometer exercise with respiratory gas analysis and arterial 
      blood gas analysis were performed in 105 patients with chronic heart failure (34 
      patients in New York Heart Association [NYHA] class I, 38 patients in NYHA class 
      II, and 33 patients in NYHA class III) and 14 normal control subjects. Peak O(2) 
      uptake, excessive exercise ventilation as assessed by the slope of the relation 
      between expired minute ventilation and CO(2) output (VE-VCO(2)), and the ratio of 
      physiologic dead space to tidal volume (VD/VT) were determined. Cardiac output 
      was also measured during exercise in 28 patients with chronic heart failure. 
      Arterial PO(2) or PCO(2) values at rest and during exercise were not different 
      among the four groups. However, end-tidal PCO(2) was significantly lower, and 
      arterial to end-tidal PCO(2) difference and VD/VT were significantly higher in 
      NYHA class III patients than other groups during exercise. The maximal end-tidal 
      PCO(2) during exercise was significantly reduced as the severity of chronic heart 
      failure advanced (45.7 +/- 4.0 mm Hg in normal control subjects, 43.5 +/- 4.8 mm 
      Hg in NYHA class I patients, 39.7 +/- 5.1 mm Hg in NYHA class II patients, and 
      34.9 +/- 5.3 mm Hg in NYHA class III patients). The maximal end-tidal PCO(2) 
      during exercise was significantly correlated with peak O(2) uptake (r = 0.68; p < 
      0.001) and maximal cardiac index (r = 0.73; p < 0.001), and inversely related to 
      Ve-VCO(2) (r = - 0.84; p < 0.001) and VD/VT at peak exercise (r = -0.65; p < 
      0.001). CONCLUSIONS: The decreased end-tidal PCO(2) during exercise, which is 
      caused by high ventilation/perfusion ratio mismatching, reflects both reduced 
      cardiac output response to exercise and increased exercise ventilation due to 
      enlarged physiologic dead space in advanced chronic heart failure. The end-tidal 
      PCO(2) during exercise can be used to evaluate the functional capacity of 
      patients with chronic heart failure.
FAU - Tanabe, Y
AU  - Tanabe Y
AD  - Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, 
      Japan.
FAU - Hosaka, Y
AU  - Hosaka Y
FAU - Ito, M
AU  - Ito M
FAU - Ito, E
AU  - Ito E
FAU - Suzuki, K
AU  - Suzuki K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
MH  - Carbon Dioxide/*physiology
MH  - Cardiac Output
MH  - Case-Control Studies
MH  - Exercise Test
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Heart Failure/diagnosis/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Respiratory Dead Space
MH  - Respiratory Function Tests
EDAT- 2001/03/13 10:00
MHDA- 2001/04/21 10:01
CRDT- 2001/03/13 10:00
PHST- 2001/03/13 10:00 [pubmed]
PHST- 2001/04/21 10:01 [medline]
PHST- 2001/03/13 10:00 [entrez]
AID - S0012-3692(15)51678-4 [pii]
AID - 10.1378/chest.119.3.811 [doi]
PST - ppublish
SO  - Chest. 2001 Mar;119(3):811-7. doi: 10.1378/chest.119.3.811.