Noninvasive Ventilation Before Maximum Exercise Test Increases Exercise Tolerance in Subjects With Heart Failure: A Crossover Study.

OBJECTIVE

To evaluate the effect of noninvasive ventilation (NIV) on exercise performance in individuals with heart failure (HF).

DESIGN

Crossover, blind, randomized controlled trial with allocation concealment.

SETTING

University-based research laboratory.

PARTICIPANTS

Participants (N=24) with New York Heart Association class II and III left heart failure and with a mean age of 51.8±10.2 years (women: n=8; men: n=16).

INTERVENTIONS

Ventilatory support attached to the face of the individual via a facemask prior to cardiopulmonary exercise test (CPET) was administered at 2 pressure levels for 30 minutes. Inspiratory pressure of 15cmHO and expiratory pressure of 5cmHO were applied.

MAIN OUTCOME MEASURES

Maximal oxygen uptake, maximum heart rate, variation between the initial and maximum heart rates, CPET duration, and recovery time oxygen consumption.

RESULTS

Differences were observed in maximal oxygen consumption (nonintervention phase: 18.3±4.4mL·kg·min vs NIV phase: 20.6±4.9mL·kg·min, P=.01), heart rate (nonintervention phase: 127.3±20.9 beats per minute vs NIV phase: 134.7±19.5 beats per minute, P=.04), and heart rate variation (nonintervention phase: 63.3%±19.3% vs NIV phase: 69.7%±16.6%, P=.02). Moreover, differences in cardiopulmonary exercise time (nonintervention phase: 7.4±1.5min vs NIV phase: 8.3±1.7min, P=.01) and oxygen consumption recovery time (nonintervention phase: 2.8±1.0min vs NIV phase: 2.4±0.8min, P=.01) were observed.

CONCLUSIONS

NIV elicited beneficial effects in the HF population that included increased exercise tolerance, recovery time optimization, and improved chronotropic and respiratory reserves.