Effects of severity of long-standing congestive heart failure on pulmonary function

To investigate the effects of severity of long-standing congestive heart failure (CHF) on pulmonary function, we studied 53 (47 men) consecutive patients, all heart transplant candidates. Their mean (± sd) age and ejection fraction were 47 ± 12 years and 23 ± 7%, respectively. All patients underwent spirometry, lung volume, diffusion capacity ( D lCO), maximum inspiratory ( P imax) and expiratory pressure ( P emax) measurement. Maximum cardiopulmonary exercise test on a treadmill was also performed to determine maximum oxygen consumption ( V ̇ O 2max ). On the basis of V ̇ O 2max , the patients were then divided into those with a V ̇ O 2max > 14 ml min −1 kg −1 (group 1, n=30) and those with a V ̇ O 2max ≤ 14 ml min −1 kg −1 (group 2, n=23). In comparison with group 1, group 2 patients had lower FEV 1 FVC (70 ± 8% vs 75 ± 7%, P=0·008), lower FEF 25–75 (46 ± 21 vs 70 ± 26%pred, P