1 Division of Cardiology, Istituti Clinici Scientifici Maugeri, Italy.
2 Department of Medicine and Health Sciences, University of Molise, Italy.
Eur J Prev Cardiol. 2018 Nov;25(17):1838-1842. doi: 10.1177/2047487318801415. Epub 2018 Sep 24.
Exercise oscillatory ventilation is an ominous outcome sign in heart failure due to reduced left ventricular ejection fraction; currently, the prevalence of exercise oscillatory ventilation is unknown in left ventricular assist device recipients.
We studied cardiopulmonary exercise testing in heart failure due to reduced left ventricular ejection fraction or left ventricular assist device patients and exercise oscillatory ventilation was defined according to Kremser's criteria.
The occurrence of exercise oscillatory ventilation was similar in either heart failure due to reduced left ventricular ejection fraction (192 patients, 8%) or left ventricular assist device patients (85 recipients, 10%), even though the mean peak oxygen consumption and elevated ventilatory response to exercise slope was lower and higher in left ventricular assist device recipients, respectively, but the occurrence of exercise oscillatory ventilation was comparable among heart failure patients due to reduced left ventricular ejection fraction and left ventricular assist device, if those with impaired exercise capacity were considered. Of note, left ventricular assist device recipients with exercise oscillatory ventilation had a higher end-diastolic left ventricular volume and systolic pulmonary artery pressure at rest.
Using the largest cohort of left ventricular assist device patients performing cardiopulmonary exercise testing, we demonstrated that the occurrence of exercise oscillatory ventilation is similar in heart failure due to reduced left ventricular ejection fraction and left ventricular assist device patients. Recipients with exercise oscillatory ventilation might have haemodynamic and ventilatory dysfunction during exercise, but other factors could play a role, i.e. the duration and severity of heart failure before left ventricular assist device implantation together with the coexistence of morbidity.
在射血分数降低的心力衰竭患者中，运动性振荡通气是一个预后不良的征象；目前，尚不清楚左心室辅助装置（LVAD）受者中运动性振荡通气的发生率。
我们研究了射血分数降低的心力衰竭或 LVAD 患者的心肺运动测试，并根据 Kremser 的标准定义运动性振荡通气。
射血分数降低的心力衰竭患者（192 例，8%）和 LVAD 患者（85 例，10%）运动性振荡通气的发生率相似，尽管 LVAD 患者的平均峰值摄氧量和运动时通气反应斜率升高，但运动能力受损的心力衰竭患者和 LVAD 患者的运动性振荡通气发生率相似。值得注意的是，运动性振荡通气的 LVAD 患者在静息时的左心室舒张末期容积和收缩期肺动脉压较高。
使用接受心肺运动测试的最大 LVAD 患者队列，我们表明，射血分数降低的心力衰竭和 LVAD 患者的运动性振荡通气发生率相似。运动性振荡通气的受者在运动时可能存在血液动力学和通气功能障碍，但其他因素也可能起作用，即 LVAD 植入前心力衰竭的持续时间和严重程度以及并存疾病。
Zotero 插件