Tokmakova M, Kostianev S, Dobreva B, Djurdjev A
Department of Internal Medicine, Higher Medical Institute, Plovdiv, Bulgaria.
Folia Med (Plovdiv). 1999;41(4):12-8.
A comprehensive assessment of the ventilatory functions of patients with chronic heart failure (CHF) both at rest and during a cardiopulmonary exercise test (CPET). We studied 42 males, divided into two groups--patients with CHF (n = 21) and age, weight, height and BMI matched healthy controls (n = 21). All subjects underwent a symptom-limited ramp CPET, arterial blood gas analysis, and complex functional examination of the pulmonary system. Subjective rating of dyspnea and exertion were measured by the Borg and ATS dyspnea scales. CHF patients showed a slight, but statistically significant decrease of the spirographic and diffusion parameters, as well as of the indices of respiratory muscle strength. There were no changes in blood gases and in tidal breathing parameters. The exercise capacity was markedly reduced (VO2peak ml.min-1 1352 +/- 335 CHF patients vs 2077 +/- 276 healthy controls; p < 0.001) and the anaerobic threshold occurred earlier (< 40% of predicted VO2peak) during CPET in CHF patients. The increase in VE/VCO2 in CHF patients (35.7 +/- 5.1 CHF; 28.9 +/- 2.5 HC, p < 0.001) indicates a compromised ventilatory efficiency which leads to a higher dyspneic cost of exercise (Borg peak 9.5 +/- 1.03 CHF; 6.0 +/- 1.28 HC; p < 0.001) as compared with healthy controls.
对慢性心力衰竭（CHF）患者在静息状态和心肺运动试验（CPET）期间的通气功能进行全面评估。我们研究了42名男性，分为两组——CHF患者（n = 21）和年龄、体重、身高及体重指数相匹配的健康对照者（n = 21）。所有受试者均接受了症状限制的递增式CPET、动脉血气分析以及肺部系统的综合功能检查。通过Borg和ATS呼吸困难量表对呼吸困难和用力程度进行主观评分。CHF患者的肺量计和弥散参数以及呼吸肌力量指标略有下降，但具有统计学意义。血气和潮式呼吸参数无变化。CHF患者的运动能力明显降低（CHF患者的峰值摄氧量ml.min-1为1352±335，健康对照者为2077±276；p < 0.001），且在CPET期间无氧阈值出现得更早（<预测峰值摄氧量的40%）。CHF患者的VE/VCO2升高（CHF患者为35.7±5.1；健康对照者为28.9±2.5，p < 0.001），这表明通气效率受损，导致与健康对照者相比运动时呼吸困难代价更高（Borg峰值：CHF患者为9.5±1.03；健康对照者为6.0±1.28；p < 0.001）。
