Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
J Appl Physiol (1985). 2022 Jan 1;132(1):36-45. doi: 10.1152/japplphysiol.00474.2021. Epub 2021 Nov 11.
Patients with heart failure with preserved ejection fraction (HFpEF) exhibit cardiopulmonary abnormalities that could affect the predictability of exercise [Formula: see text] from the Jones corrected partial pressure of end-tidal CO (PJ) equation (PJ = 5.5 + 0.9 × [Formula: see text] - 2.1 × V). Since the dead space to tidal volume (V/V) calculation also includes [Formula: see text] measurements, estimates of V/V from PJ may also be affected. Because using noninvasive estimates of [Formula: see text] and V/V could save patient discomfort, time, and cost, we examined whether partial pressure of end-tidal CO ([Formula: see text]) and PJ can be used to estimate [Formula: see text] and V/V in 13 patients with HFpEF. [Formula: see text] was measured from expired gases measured simultaneously with radial arterial blood gases at rest, constant-load (20 W), and peak exercise. V/V was calculated using the Enghoff modification of the Bohr equation, and estimates of V/V were calculated using [Formula: see text] (V/V) and PJ (V/V) in place of [Formula: see text]. [Formula: see text] was similar to [Formula: see text] at rest (-1.46 ± 2.63, = 0.112) and peak exercise (0.66 ± 2.56, = 0.392), but overestimated [Formula: see text] at 20 W (-2.09 ± 2.55, = 0.020). PJ was similar to [Formula: see text] at rest (-1.29 ± 2.57, = 0.119) and 20 W (-1.06 ± 2.29, = 0.154), but underestimated [Formula: see text] at peak exercise (1.90 ± 2.13, = 0.009). V/V was similar to V/V at rest (-0.01 ± 0.03, = 0.127) and peak exercise (0.01 ± 0.04, = 0.210), but overestimated V/V at 20 W (-0.02 ± 0.03, = 0.025). Although V/V was similar to V/V at rest (-0.01 ± 0.03, = 0.156) and 20 W (-0.01 ± 0.03, = 0.133), V/V underestimated V/V at peak exercise (0.03 ± 0.04, = 0.013). Exercise [Formula: see text] and V/V provides better estimates of [Formula: see text] and V/V than PJ and V/V does at peak exercise. Thus, estimates of [Formula: see text] and V/V should only be used if sampling arterial blood during CPET is not feasible. [Formula: see text] provides a better estimate of [Formula: see text] than PJ at peak exercise, and V/V provides a better estimate of V/V than V/V at peak exercise. Although we reported significant correlations, we did not find an identity between [Formula: see text] and estimates of [Formula: see text], nor did we find an identity between V/V and estimates of V/V. Thus, caution should be taken and estimates of [Formula: see text] and V/V should only be used if sampling arterial blood during CPET is not feasible.
射血分数保留的心力衰竭(HFpEF)患者表现出心肺异常,这可能会影响从琼斯校正的潮气末二氧化碳分压(PJ)方程(PJ = 5.5 + 0.9 × [Formula: see text] - 2.1 × V)中预测运动[Formula: see text]的能力。由于死腔与潮气量(V/V)的计算也包括[Formula: see text]测量,因此 PJ 估计的 V/V 也可能受到影响。因为使用无创估计[Formula: see text]和 V/V 可以节省患者的不适、时间和成本,所以我们检查了在 13 名 HFpEF 患者中,是否可以使用潮气末二氧化碳分压([Formula: see text])和 PJ 来估计[Formula: see text]和 V/V。[Formula: see text]是从同时测量的静息、恒负荷(20 W)和峰值运动时的桡动脉血气中测量的。V/V 使用 Enghoff 对 Bohr 方程的修正进行计算,并且使用[Formula: see text](V/V)和 PJ(V/V)代替[Formula: see text]计算 V/V 的估计值。[Formula: see text]与静息时的[Formula: see text]相似(-1.46 ± 2.63, = 0.112)和峰值运动时(0.66 ± 2.56, = 0.392),但在 20 W 时高估[Formula: see text](-2.09 ± 2.55, = 0.020)。PJ 在静息时与[Formula: see text]相似(-1.29 ± 2.57, = 0.119)和 20 W 时相似(-1.06 ± 2.29, = 0.154),但在峰值运动时低估[Formula: see text](1.90 ± 2.13, = 0.009)。V/V 在静息时与 V/V 相似(-0.01 ± 0.03, = 0.127)和峰值运动时相似(0.01 ± 0.04, = 0.210),但在 20 W 时高估 V/V(-0.02 ± 0.03, = 0.025)。尽管 V/V 在静息时与 V/V 相似(-0.01 ± 0.03, = 0.156)和 20 W 时相似(-0.01 ± 0.03, = 0.133),但 V/V 在峰值运动时低估了 V/V(0.03 ± 0.04, = 0.013)。在峰值运动时,运动[Formula: see text]和 V/V 比 PJ 和 V/V 提供了更好的[Formula: see text]和 V/V 估计值。因此,如果在 CPET 期间不能采样动脉血,则只能使用[Formula: see text]和 V/V 的估计值。[Formula: see text]在峰值运动时比 PJ 提供了更好的[Formula: see text]估计值,而 V/V 在峰值运动时比 V/V 提供了更好的 V/V 估计值。尽管我们报告了显著的相关性,但我们没有发现[Formula: see text]和估计的[Formula: see text]之间存在同一性,也没有发现 V/V 和估计的 V/V 之间存在同一性。因此,应该谨慎使用[Formula: see text]和 V/V 的估计值,如果在 CPET 期间不能采样动脉血,则只能使用它们。