Buller N P, Poole-Wilson P A
National Heart and Lung Institute, National Heart Hospital, London.
Br Heart J. 1990 May;63(5):281-3. doi: 10.1136/hrt.63.5.281.
Minute ventilation, respiratory rate, and metabolic gas exchange were measured continuously during maximal symptom limited treadmill exercise in 30 patients with stable chronic heart failure. The ventilatory response to exercise was assessed by calculation of the slope of the relation between minute ventilation and rate of carbon dioxide production. There was a close correlation between the severity of heart failure, determined as the maximal rate of oxygen consumption, and the ventilatory response to exercise. Reanalysis of the data after correction for ventilation of anatomical dead space did not significantly weaken the correlation but reduced the slope of the relation by approximately one third. These results show that the increased ventilatory response to exercise in patients with chronic heart failure is largely caused by mechanisms other than increased ventilation of anatomical dead space. This finding supports the concept that a significant pulmonary ventilation/perfusion mismatch develops in patients with chronic heart failure and suggests that the magnitude of this abnormality is directly related to the severity of chronic heart failure.
在30例稳定型慢性心力衰竭患者进行症状限制的最大强度跑步机运动期间，持续测量每分通气量、呼吸频率和代谢气体交换。通过计算每分通气量与二氧化碳产生率之间关系的斜率来评估运动的通气反应。心力衰竭的严重程度（以最大耗氧率确定）与运动的通气反应之间存在密切相关性。在校正解剖无效腔通气后重新分析数据，并未显著削弱这种相关性，但使该关系的斜率降低了约三分之一。这些结果表明，慢性心力衰竭患者运动时通气反应增加主要由解剖无效腔通气增加以外的机制引起。这一发现支持了慢性心力衰竭患者会出现明显肺通气/灌注不匹配的概念，并表明这种异常的程度与慢性心力衰竭的严重程度直接相关。
