Effects of increased inspired oxygen concentrations on exercise performance in chronic heart failure

Exercise capacity in patients with stable heart failure may be influenced by prolonged drug treatment or exercise training, but acute interventions are generally thought to have little effect. Cardiorespiratory responses to exercise were studied in 12 consecutive patients with chronic congestive heart failure who underwent serial submaximal and maximal exercise tests at inspired oxygen concentrations of 21% (room air), 30%, and 50%. Mean (SD) exercise duration during progressive testing to maximum exercise capacity was prolonged from 548 (276) s on room air to 632 (285) s on 50% oxygen (p=0·012). During steady-state exercise at 45 W, oxygen enrichment to 50% was associated with significantly increased arterial oxygen saturation (94·6 [1·9] % to 97·5 [1·3] %), and significantly reduced minute ventilation (36·1 [8·6] l/min to 28·1 [5·9] l/min), cardiac output (7·5 [2·3] l/min to 6·5 [1 ·9] l/min), and subjective scores for fatigue and breathlessness (13·9 [3·1] to 11·5 [3·5]) compared with room air; intermediate changes were observed with 30% inspired oxygen. Increased inspired oxygen concentrations can improve exercise performance acutely and modify the ventilatory response to exercise in patients with heart failure. Hyperoxia reduces ventilatory response and circulatory demand while maintaining oxygen delivery at a given workload. The potential benefits of increased inspired oxygen concentrations in the treatment of chronic heart failure merit further assessment.