Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance
Purpose Cardiopulmonary exercise testing (CPX) is used to evaluate functional capacity and assess prognosis in cardiac patients. Ventilatory efficiency (VE/VCO 2 ) reflects ventilation–perfusion mismatch; the minimum VE/VCO 2 value (minVE/VCO 2 ) is representative of pulmonary arterial blood flow in...
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| Veröffentlicht in: | European journal of applied physiology 2018-08, Vol.118 (8), p.1547-1553 |
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| creator | Nakade, Taisuke Adachi, Hitoshi Murata, Makoto Oshima, Shigeru |
| description | Purpose
Cardiopulmonary exercise testing (CPX) is used to evaluate functional capacity and assess prognosis in cardiac patients. Ventilatory efficiency (VE/VCO
2
) reflects ventilation–perfusion mismatch; the minimum VE/VCO
2
value (minVE/VCO
2
) is representative of pulmonary arterial blood flow in individuals without pulmonary disease. Usually, minVE/VCO
2
has a strong relationship with the peak oxygen uptake (VO
2
), but dissociation can occur. Therefore, we investigated the relationship between minVE/VCO
2
and predicted peak VO
2
(peak VO
2
%) and evaluated the parameters associated with a discrepancy between these two parameters.
Methods
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 VO
2
% lower than 70% were enrolled. Patients were divided into groups based on their minVE/VCO
2
[Low group: minVE/VCO
2
mean + SD (38.8 + 5.6)]. The characteristics and cardiac function at rest, evaluated using echocardiography, were compared between groups.
Results
The High group had a significantly lower ejection fraction, stroke volume, and cardiac output, and higher brain natriuretic peptide, tricuspid regurgitation pressure gradient, right ventricular systolic pressure, and peak early diastolic LV filling velocity/peak atrial filling velocity ratio compared with the Low group (
p
’s |
| doi_str_mv | 10.1007/s00421-018-3884-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2039295965</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2038477205</sourcerecordid><originalsourceid>FETCH-LOGICAL-c392t-9a7b8b8d394b417ee38bcf28bc383b83b7bceeafcc813e1671099288afd4f6d53</originalsourceid><addsrcrecordid>eNp1kdtKAzEQhhdRsB4ewLuACN6szWHtJpdS6gEKvdHehtnsbBvdk0lq7dubpaIgCMPMMHz_zMCfJBeM3jBK87GnNOMspUymQsosZQfJiGVCpRPB88Ofnqnj5MT7V0qp5EyOku10DQ5MQGd9sMaTriI9BItt8GRrw5oAcVjHyQfWO7JyCJEljW1ts2nIcjZeThecwAps6wPpEd7IcsGvCLQlsU0P1mFJ8BOdsR5J6Gp00Bo8S44qqD2ef9fT5OV-9jx9TOeLh6fp3Tw1QvGQKsgLWchSqKzIWI4oZGEqHpOQooiRFwYRKmMkE8gmOaNKcSmhKrNqUt6K0-R6v7d33fsGfdCN9QbrGlrsNl5zGu-oWzUZ0Ms_6Gu3cW38bqBkluecDhTbU8Z13jusdO9sA26nGdWDFXpvhY5W6MEKzaKG7zU-su0K3e_m_0VfKq-Mjg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2038477205</pqid></control><display><type>article</type><title>Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance</title><source>SpringerLink Journals - AutoHoldings</source><creator>Nakade, Taisuke ; Adachi, Hitoshi ; Murata, Makoto ; Oshima, Shigeru</creator><creatorcontrib>Nakade, Taisuke ; Adachi, Hitoshi ; Murata, Makoto ; Oshima, Shigeru</creatorcontrib><description>Purpose
Cardiopulmonary exercise testing (CPX) is used to evaluate functional capacity and assess prognosis in cardiac patients. Ventilatory efficiency (VE/VCO
2
) reflects ventilation–perfusion mismatch; the minimum VE/VCO
2
value (minVE/VCO
2
) is representative of pulmonary arterial blood flow in individuals without pulmonary disease. Usually, minVE/VCO
2
has a strong relationship with the peak oxygen uptake (VO
2
), but dissociation can occur. Therefore, we investigated the relationship between minVE/VCO
2
and predicted peak VO
2
(peak VO
2
%) and evaluated the parameters associated with a discrepancy between these two parameters.
Methods
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 VO
2
% lower than 70% were enrolled. Patients were divided into groups based on their minVE/VCO
2
[Low group: minVE/VCO
2
< mean − SD (38.8–5.6); High group: minVE/VCO
2
> mean + SD (38.8 + 5.6)]. The characteristics and cardiac function at rest, evaluated using echocardiography, were compared between groups.
Results
The High group had a significantly lower ejection fraction, stroke volume, and cardiac output, and higher brain natriuretic peptide, tricuspid regurgitation pressure gradient, right ventricular systolic pressure, and peak early diastolic LV filling velocity/peak atrial filling velocity ratio compared with the Low group (
p
’s < 0.01). In addition, the Low group had a significantly higher prevalence of pleural effusion than did the High group (26 vs 11%,
p
< 0.01).
Conclusions
Patients with a relatively greater minVE/VCO
2
in comparison with peak VO
2
had impaired cardiac output as well as restricted pulmonary blood flow increase during exercise, partly due to accumulated pleural effusion.</description><identifier>ISSN: 1439-6319</identifier><identifier>EISSN: 1439-6327</identifier><identifier>DOI: 10.1007/s00421-018-3884-1</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Biomedical and Life Sciences ; Biomedicine ; Blood flow ; Blood pressure ; Brain natriuretic peptide ; Echocardiography ; Electrocardiography ; Heart ; Heart diseases ; Human Physiology ; Lung diseases ; Mechanical ventilation ; Occupational Medicine/Industrial Medicine ; Original Article ; Perfusion ; Pleural effusion ; Regurgitation ; Sports Medicine ; Velocity ; Ventricle</subject><ispartof>European journal of applied physiology, 2018-08, Vol.118 (8), p.1547-1553</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>European Journal of Applied Physiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-9a7b8b8d394b417ee38bcf28bc383b83b7bceeafcc813e1671099288afd4f6d53</citedby><cites>FETCH-LOGICAL-c392t-9a7b8b8d394b417ee38bcf28bc383b83b7bceeafcc813e1671099288afd4f6d53</cites><orcidid>0000-0002-9491-3286</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00421-018-3884-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00421-018-3884-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids></links><search><creatorcontrib>Nakade, Taisuke</creatorcontrib><creatorcontrib>Adachi, Hitoshi</creatorcontrib><creatorcontrib>Murata, Makoto</creatorcontrib><creatorcontrib>Oshima, Shigeru</creatorcontrib><title>Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance</title><title>European journal of applied physiology</title><addtitle>Eur J Appl Physiol</addtitle><description>Purpose
Cardiopulmonary exercise testing (CPX) is used to evaluate functional capacity and assess prognosis in cardiac patients. Ventilatory efficiency (VE/VCO
2
) reflects ventilation–perfusion mismatch; the minimum VE/VCO
2
value (minVE/VCO
2
) is representative of pulmonary arterial blood flow in individuals without pulmonary disease. Usually, minVE/VCO
2
has a strong relationship with the peak oxygen uptake (VO
2
), but dissociation can occur. Therefore, we investigated the relationship between minVE/VCO
2
and predicted peak VO
2
(peak VO
2
%) and evaluated the parameters associated with a discrepancy between these two parameters.
Methods
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 VO
2
% lower than 70% were enrolled. Patients were divided into groups based on their minVE/VCO
2
[Low group: minVE/VCO
2
< mean − SD (38.8–5.6); High group: minVE/VCO
2
> mean + SD (38.8 + 5.6)]. The characteristics and cardiac function at rest, evaluated using echocardiography, were compared between groups.
Results
The High group had a significantly lower ejection fraction, stroke volume, and cardiac output, and higher brain natriuretic peptide, tricuspid regurgitation pressure gradient, right ventricular systolic pressure, and peak early diastolic LV filling velocity/peak atrial filling velocity ratio compared with the Low group (
p
’s < 0.01). In addition, the Low group had a significantly higher prevalence of pleural effusion than did the High group (26 vs 11%,
p
< 0.01).
Conclusions
Patients with a relatively greater minVE/VCO
2
in comparison with peak VO
2
had impaired cardiac output as well as restricted pulmonary blood flow increase during exercise, partly due to accumulated pleural effusion.</description><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Blood flow</subject><subject>Blood pressure</subject><subject>Brain natriuretic peptide</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Human Physiology</subject><subject>Lung diseases</subject><subject>Mechanical ventilation</subject><subject>Occupational Medicine/Industrial Medicine</subject><subject>Original Article</subject><subject>Perfusion</subject><subject>Pleural effusion</subject><subject>Regurgitation</subject><subject>Sports Medicine</subject><subject>Velocity</subject><subject>Ventricle</subject><issn>1439-6319</issn><issn>1439-6327</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kdtKAzEQhhdRsB4ewLuACN6szWHtJpdS6gEKvdHehtnsbBvdk0lq7dubpaIgCMPMMHz_zMCfJBeM3jBK87GnNOMspUymQsosZQfJiGVCpRPB88Ofnqnj5MT7V0qp5EyOku10DQ5MQGd9sMaTriI9BItt8GRrw5oAcVjHyQfWO7JyCJEljW1ts2nIcjZeThecwAps6wPpEd7IcsGvCLQlsU0P1mFJ8BOdsR5J6Gp00Bo8S44qqD2ef9fT5OV-9jx9TOeLh6fp3Tw1QvGQKsgLWchSqKzIWI4oZGEqHpOQooiRFwYRKmMkE8gmOaNKcSmhKrNqUt6K0-R6v7d33fsGfdCN9QbrGlrsNl5zGu-oWzUZ0Ms_6Gu3cW38bqBkluecDhTbU8Z13jusdO9sA26nGdWDFXpvhY5W6MEKzaKG7zU-su0K3e_m_0VfKq-Mjg</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Nakade, Taisuke</creator><creator>Adachi, Hitoshi</creator><creator>Murata, Makoto</creator><creator>Oshima, Shigeru</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9491-3286</orcidid></search><sort><creationdate>20180801</creationdate><title>Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance</title><author>Nakade, Taisuke ; Adachi, Hitoshi ; Murata, Makoto ; Oshima, Shigeru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c392t-9a7b8b8d394b417ee38bcf28bc383b83b7bceeafcc813e1671099288afd4f6d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Blood flow</topic><topic>Blood pressure</topic><topic>Brain natriuretic peptide</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Human Physiology</topic><topic>Lung diseases</topic><topic>Mechanical ventilation</topic><topic>Occupational Medicine/Industrial Medicine</topic><topic>Original Article</topic><topic>Perfusion</topic><topic>Pleural effusion</topic><topic>Regurgitation</topic><topic>Sports Medicine</topic><topic>Velocity</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakade, Taisuke</creatorcontrib><creatorcontrib>Adachi, Hitoshi</creatorcontrib><creatorcontrib>Murata, Makoto</creatorcontrib><creatorcontrib>Oshima, Shigeru</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of applied physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakade, Taisuke</au><au>Adachi, Hitoshi</au><au>Murata, Makoto</au><au>Oshima, Shigeru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance</atitle><jtitle>European journal of applied physiology</jtitle><stitle>Eur J Appl Physiol</stitle><date>2018-08-01</date><risdate>2018</risdate><volume>118</volume><issue>8</issue><spage>1547</spage><epage>1553</epage><pages>1547-1553</pages><issn>1439-6319</issn><eissn>1439-6327</eissn><abstract>Purpose
Cardiopulmonary exercise testing (CPX) is used to evaluate functional capacity and assess prognosis in cardiac patients. Ventilatory efficiency (VE/VCO
2
) reflects ventilation–perfusion mismatch; the minimum VE/VCO
2
value (minVE/VCO
2
) is representative of pulmonary arterial blood flow in individuals without pulmonary disease. Usually, minVE/VCO
2
has a strong relationship with the peak oxygen uptake (VO
2
), but dissociation can occur. Therefore, we investigated the relationship between minVE/VCO
2
and predicted peak VO
2
(peak VO
2
%) and evaluated the parameters associated with a discrepancy between these two parameters.
Methods
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 VO
2
% lower than 70% were enrolled. Patients were divided into groups based on their minVE/VCO
2
[Low group: minVE/VCO
2
< mean − SD (38.8–5.6); High group: minVE/VCO
2
> mean + SD (38.8 + 5.6)]. The characteristics and cardiac function at rest, evaluated using echocardiography, were compared between groups.
Results
The High group had a significantly lower ejection fraction, stroke volume, and cardiac output, and higher brain natriuretic peptide, tricuspid regurgitation pressure gradient, right ventricular systolic pressure, and peak early diastolic LV filling velocity/peak atrial filling velocity ratio compared with the Low group (
p
’s < 0.01). In addition, the Low group had a significantly higher prevalence of pleural effusion than did the High group (26 vs 11%,
p
< 0.01).
Conclusions
Patients with a relatively greater minVE/VCO
2
in comparison with peak VO
2
had impaired cardiac output as well as restricted pulmonary blood flow increase during exercise, partly due to accumulated pleural effusion.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00421-018-3884-1</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9491-3286</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1439-6319 |
| ispartof | European journal of applied physiology, 2018-08, Vol.118 (8), p.1547-1553 |
| issn | 1439-6319 1439-6327 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2039295965 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Biomedical and Life Sciences Biomedicine Blood flow Blood pressure Brain natriuretic peptide Echocardiography Electrocardiography Heart Heart diseases Human Physiology Lung diseases Mechanical ventilation Occupational Medicine/Industrial Medicine Original Article Perfusion Pleural effusion Regurgitation Sports Medicine Velocity Ventricle |
| title | Characteristics of patients with a relatively greater minimum VE/VCO2 against peak VO2% and impaired exercise tolerance |
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