Resting pulmonary function and artery pressure and cardiopulmonary exercise testing in chronic heart failure patients in Taiwan − a prospective observational cross-sectional study comparing healthy subjects and interstitial lung disease patients
Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the...
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| Published in: | Annals of medicine (Helsinki) Vol. 55; no. 1; p. 2228696 |
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| Language: | English |
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England
Taylor & Francis
12.12.2023
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| ISSN: | 0785-3890, 1365-2060, 1365-2060 |
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| Abstract | Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the pathophysiology may be different between them. This study aimed to investigate: (1) PAP and lung function at rest, (2) pulmonary gas exchange (PGX) and breathing patterns at peak exercise, (3) mechanisms of dyspnea at peak exercise in patients with CHF compared to healthy subjects and ILD patients.
We consecutively enrolled 83 participants (27 with CHF, 23 with ILD, and 33 healthy controls). The CHF and ILD groups had similar functional status. Lung function and cardiopulmonary exercise tests with Borg Dyspnea Score were performed. PAP was estimated using echocardiography. Resting lung function, PAP and peak exercise data in the CHF group were compared to the healthy and ILD groups. Correlation analysis was performed to elucidate the mechanisms of dyspnea in the CHF and ILD groups.
Compared to the healthy group, the CHF group had normal lung function, PAP at rest, and normal dyspnea score and PGX at peak exercise, whereas the ILD group had abnormal values compared to the CHF group. Dyspnea score was positively correlated with pressure gradient, lung expansion capabilities, and expiratory tidal flow in the CHF group (all p < 0.05), but inversely correlated with inspiratory time-related variables in the ILD group (all p < 0.05).
Normal lung function and PAP at rest, and dyspnea scores and PGX at peak exercise indicated that pulmonary hypertension and fibrosis were insignificant in the patients with CHF. The factors affecting dyspnea at peak exercise were different between the CHF and ILD groups. As the sample size in this study was small, large-scale studies are warranted to confirm our findings. |
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| AbstractList | Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the pathophysiology may be different between them. This study aimed to investigate: (1) PAP and lung function at rest, (2) pulmonary gas exchange (PGX) and breathing patterns at peak exercise, (3) mechanisms of dyspnea at peak exercise in patients with CHF compared to healthy subjects and ILD patients.BACKGROUNDRestrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the pathophysiology may be different between them. This study aimed to investigate: (1) PAP and lung function at rest, (2) pulmonary gas exchange (PGX) and breathing patterns at peak exercise, (3) mechanisms of dyspnea at peak exercise in patients with CHF compared to healthy subjects and ILD patients.We consecutively enrolled 83 participants (27 with CHF, 23 with ILD, and 33 healthy controls). The CHF and ILD groups had similar functional status. Lung function and cardiopulmonary exercise tests with Borg Dyspnea Score were performed. PAP was estimated using echocardiography. Resting lung function, PAP and peak exercise data in the CHF group were compared to the healthy and ILD groups. Correlation analysis was performed to elucidate the mechanisms of dyspnea in the CHF and ILD groups.METHODSWe consecutively enrolled 83 participants (27 with CHF, 23 with ILD, and 33 healthy controls). The CHF and ILD groups had similar functional status. Lung function and cardiopulmonary exercise tests with Borg Dyspnea Score were performed. PAP was estimated using echocardiography. Resting lung function, PAP and peak exercise data in the CHF group were compared to the healthy and ILD groups. Correlation analysis was performed to elucidate the mechanisms of dyspnea in the CHF and ILD groups.Compared to the healthy group, the CHF group had normal lung function, PAP at rest, and normal dyspnea score and PGX at peak exercise, whereas the ILD group had abnormal values compared to the CHF group. Dyspnea score was positively correlated with pressure gradient, lung expansion capabilities, and expiratory tidal flow in the CHF group (all p < 0.05), but inversely correlated with inspiratory time-related variables in the ILD group (all p < 0.05).RESULTSCompared to the healthy group, the CHF group had normal lung function, PAP at rest, and normal dyspnea score and PGX at peak exercise, whereas the ILD group had abnormal values compared to the CHF group. Dyspnea score was positively correlated with pressure gradient, lung expansion capabilities, and expiratory tidal flow in the CHF group (all p < 0.05), but inversely correlated with inspiratory time-related variables in the ILD group (all p < 0.05).Normal lung function and PAP at rest, and dyspnea scores and PGX at peak exercise indicated that pulmonary hypertension and fibrosis were insignificant in the patients with CHF. The factors affecting dyspnea at peak exercise were different between the CHF and ILD groups. As the sample size in this study was small, large-scale studies are warranted to confirm our findings.CONCLUSIONNormal lung function and PAP at rest, and dyspnea scores and PGX at peak exercise indicated that pulmonary hypertension and fibrosis were insignificant in the patients with CHF. The factors affecting dyspnea at peak exercise were different between the CHF and ILD groups. As the sample size in this study was small, large-scale studies are warranted to confirm our findings. AbstractBackground Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the pathophysiology may be different between them. This study aimed to investigate: (1) PAP and lung function at rest, (2) pulmonary gas exchange (PGX) and breathing patterns at peak exercise, (3) mechanisms of dyspnea at peak exercise in patients with CHF compared to healthy subjects and ILD patients.Methods We consecutively enrolled 83 participants (27 with CHF, 23 with ILD, and 33 healthy controls). The CHF and ILD groups had similar functional status. Lung function and cardiopulmonary exercise tests with Borg Dyspnea Score were performed. PAP was estimated using echocardiography. Resting lung function, PAP and peak exercise data in the CHF group were compared to the healthy and ILD groups. Correlation analysis was performed to elucidate the mechanisms of dyspnea in the CHF and ILD groups.Results Compared to the healthy group, the CHF group had normal lung function, PAP at rest, and normal dyspnea score and PGX at peak exercise, whereas the ILD group had abnormal values compared to the CHF group. Dyspnea score was positively correlated with pressure gradient, lung expansion capabilities, and expiratory tidal flow in the CHF group (all p < 0.05), but inversely correlated with inspiratory time-related variables in the ILD group (all p < 0.05).Conclusion Normal lung function and PAP at rest, and dyspnea scores and PGX at peak exercise indicated that pulmonary hypertension and fibrosis were insignificant in the patients with CHF. The factors affecting dyspnea at peak exercise were different between the CHF and ILD groups. As the sample size in this study was small, large-scale studies are warranted to confirm our findings. Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the pathophysiology may be different between them. This study aimed to investigate: (1) PAP and lung function at rest, (2) pulmonary gas exchange (PGX) and breathing patterns at peak exercise, (3) mechanisms of dyspnea at peak exercise in patients with CHF compared to healthy subjects and ILD patients. We consecutively enrolled 83 participants (27 with CHF, 23 with ILD, and 33 healthy controls). The CHF and ILD groups had similar functional status. Lung function and cardiopulmonary exercise tests with Borg Dyspnea Score were performed. PAP was estimated using echocardiography. Resting lung function, PAP and peak exercise data in the CHF group were compared to the healthy and ILD groups. Correlation analysis was performed to elucidate the mechanisms of dyspnea in the CHF and ILD groups. Compared to the healthy group, the CHF group had normal lung function, PAP at rest, and normal dyspnea score and PGX at peak exercise, whereas the ILD group had abnormal values compared to the CHF group. Dyspnea score was positively correlated with pressure gradient, lung expansion capabilities, and expiratory tidal flow in the CHF group (all < 0.05), but inversely correlated with inspiratory time-related variables in the ILD group (all < 0.05). Normal lung function and PAP at rest, and dyspnea scores and PGX at peak exercise indicated that pulmonary hypertension and fibrosis were insignificant in the patients with CHF. The factors affecting dyspnea at peak exercise were different between the CHF and ILD groups. As the sample size in this study was small, large-scale studies are warranted to confirm our findings. Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with interstitial lung disease (ILD). However, as oxyhemoglobin desaturation seldom occurs in stable CHF patients at peak exercise, we hypothesized that the pathophysiology may be different between them. This study aimed to investigate: (1) PAP and lung function at rest, (2) pulmonary gas exchange (PGX) and breathing patterns at peak exercise, (3) mechanisms of dyspnea at peak exercise in patients with CHF compared to healthy subjects and ILD patients. We consecutively enrolled 83 participants (27 with CHF, 23 with ILD, and 33 healthy controls). The CHF and ILD groups had similar functional status. Lung function and cardiopulmonary exercise tests with Borg Dyspnea Score were performed. PAP was estimated using echocardiography. Resting lung function, PAP and peak exercise data in the CHF group were compared to the healthy and ILD groups. Correlation analysis was performed to elucidate the mechanisms of dyspnea in the CHF and ILD groups. Compared to the healthy group, the CHF group had normal lung function, PAP at rest, and normal dyspnea score and PGX at peak exercise, whereas the ILD group had abnormal values compared to the CHF group. Dyspnea score was positively correlated with pressure gradient, lung expansion capabilities, and expiratory tidal flow in the CHF group (all p < 0.05), but inversely correlated with inspiratory time-related variables in the ILD group (all p < 0.05). Normal lung function and PAP at rest, and dyspnea scores and PGX at peak exercise indicated that pulmonary hypertension and fibrosis were insignificant in the patients with CHF. The factors affecting dyspnea at peak exercise were different between the CHF and ILD groups. As the sample size in this study was small, large-scale studies are warranted to confirm our findings. |
| Author | Sia, Sung-Kien Chang, Kai-Wei Chuang, Ming-Lung |
| Author_xml | – sequence: 1 givenname: Ming-Lung surname: Chuang fullname: Chuang, Ming-Lung organization: School of Medicine, Chung Shan Medical University – sequence: 2 givenname: Sung-Kien surname: Sia fullname: Sia, Sung-Kien organization: Department of Internal Medicine, Division of Cardiology, Chung-Shan Medical University Hospital – sequence: 3 givenname: Kai-Wei surname: Chang fullname: Chang, Kai-Wei organization: Department of Internal Medicine, Division of Cardiology, Chung-Shan Medical University Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37387199$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1097_MD_0000000000039741 crossref_primary_10_1371_journal_pdig_0000592 crossref_primary_10_1016_j_resp_2024_104242 |
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| Keywords | breathing pattern Lung function ejection fraction cardiopulmonary exercise testing pulmonary hypertension |
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| References_xml | – start-page: 183 volume-title: Principles of exercise testing and interpretation year: 2005 ident: e_1_3_6_16_1 – ident: e_1_3_6_8_1 doi: 10.1016/j.cardfail.2006.10.018 – start-page: 1609 volume-title: Murray and Nadel’s textbook of respiratory medicine year: 2005 ident: e_1_3_6_27_1 – ident: e_1_3_6_2_1 doi: 10.1093/eurheartj/ehl302 – ident: e_1_3_6_39_1 doi: 10.1183/16000617.0101-2018 – ident: e_1_3_6_40_1 doi: 10.1155/2013/956081 – ident: e_1_3_6_47_1 doi: 10.1155/2012/952741 – ident: e_1_3_6_54_1 doi: 10.3978/j.issn.2072-1439.2015.04.17 – ident: e_1_3_6_18_1 doi: 10.1016/j.ijcard.2018.08.083 – ident: e_1_3_6_12_1 doi: 10.1161/01.cir.96.7.2221 – ident: e_1_3_6_45_1 doi: 10.1378/chest.124.3.1090 – ident: e_1_3_6_46_1 doi: 10.1161/01.cir.91.11.2769 – ident: e_1_3_6_11_1 doi: 10.1183/16000617.0355-2020 – ident: e_1_3_6_20_1 doi: 10.1016/j.jacc.2020.06.069 – ident: e_1_3_6_30_1 doi: 10.1016/j.echo.2010.05.010 – ident: e_1_3_6_35_1 doi: 10.1038/s41598-019-43893-1 – ident: e_1_3_6_43_1 doi: 10.1016/j.jacc.2017.01.051 – ident: e_1_3_6_6_1 doi: 10.1161/01.cir.86.3.909 – ident: e_1_3_6_37_1 doi: 10.1007/s11739-013-0989-8 – ident: e_1_3_6_17_1 doi: 10.1183/20734735.0316-2019 – ident: e_1_3_6_42_1 doi: 10.1161/CIRCULATIONAHA.111.085761 – ident: e_1_3_6_31_1 doi: 10.7717/peerj.7829 – ident: e_1_3_6_4_1 doi: 10.1016/j.jacc.2018.06.049 – ident: e_1_3_6_34_1 doi: 10.2169/internalmedicine.49.3094 – ident: e_1_3_6_3_1 doi: 10.1002/ehf2.13342 – ident: e_1_3_6_22_1 doi: 10.1093/ehjci/jeab065 – ident: e_1_3_6_51_1 doi: 10.1111/resp.13250 – ident: e_1_3_6_38_1 doi: 10.2147/COPD.S76209 – ident: e_1_3_6_36_1 doi: 10.1164/rccm.167.2.211 – ident: e_1_3_6_10_1 doi: 10.1183/09031936.00125011 – ident: e_1_3_6_5_1 doi: 10.1164/rccm.201504-0841OC – volume: 3 start-page: 30 issue: 1 year: 2019 ident: e_1_3_6_52_1 article-title: The prevalence rate of cigarette smoking among congestive heart failure patients at a local family health center publication-title: Ann Public Health Rep – ident: e_1_3_6_9_1 doi: 10.1136/hrt.81.6.618 – ident: e_1_3_6_7_1 doi: 10.1093/eurjhf/hfn013 – ident: e_1_3_6_26_1 doi: 10.1093/eurheartj/ehn309 – ident: e_1_3_6_48_1 doi: 10.1016/0735-1097(91)90605-9 – ident: e_1_3_6_13_1 doi: 10.1378/chest.117.2.321 – ident: e_1_3_6_21_1 doi: 10.1002/ehf2.12316 – ident: e_1_3_6_23_1 doi: 10.1161/CIRCRESAHA.118.313832 – ident: e_1_3_6_24_1 doi: 10.1016/j.jcmg.2018.12.031 – ident: e_1_3_6_44_1 doi: 10.1067/mhj.2000.110282 – start-page: 1571 volume-title: Murray and Nadel’s textbook of respiratory medicine year: 2005 ident: e_1_3_6_28_1 – ident: e_1_3_6_49_1 doi: 10.1016/j.jacc.2013.10.036 – ident: e_1_3_6_53_1 doi: 10.1016/j.rmed.2011.03.004 – ident: e_1_3_6_15_1 doi: 10.1152/jappl.1980.49.3.506 – ident: e_1_3_6_50_1 doi: 10.3390/jcm8101641 – ident: e_1_3_6_25_1 doi: 10.1016/j.jchf.2013.05.001 – ident: e_1_3_6_32_1 doi: 10.1053/rmed.2001.1115 – ident: e_1_3_6_19_1 doi: 10.1093/eurheartj/ehi023 – start-page: 133 volume-title: Principles of exercise testing and interpretation year: 2005 ident: e_1_3_6_33_1 – ident: e_1_3_6_14_1 doi: 10.1152/jappl.1994.77.2.963 – ident: e_1_3_6_41_1 doi: 10.1097/MD.0000000000005471 – ident: e_1_3_6_29_1 doi: 10.3390/jpm12050703 |
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| Snippet | Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and those with... AbstractBackground Restrictive ventilatory defects and elevated pulmonary artery pressure (PAP) are common in patients with chronic heart failure (CHF) and... |
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| SubjectTerms | Arteries breathing pattern cardiopulmonary exercise testing Chronic Disease Cross-Sectional Studies Dyspnea - etiology ejection fraction Exercise Test Healthy Volunteers Heart Failure Humans Lung Lung Diseases, Interstitial - diagnosis Lung function Prospective Studies pulmonary hypertension Pulmonary Medicine Taiwan - epidemiology |
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| Title | Resting pulmonary function and artery pressure and cardiopulmonary exercise testing in chronic heart failure patients in Taiwan − a prospective observational cross-sectional study comparing healthy subjects and interstitial lung disease patients |
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