Eser Prisca, Calamai Pietro, Kalberer Anja, Stuetz Laura, Huber Sarina, Kaesermann Dominic, Guler Sabina, Wilhelm Matthias
Centre for Rehabilitation and Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Front Physiol. 2024 Aug 6;15:1380562. doi: 10.3389/fphys.2024.1380562. eCollection 2024.
To assess whether nasal breathing improves exercise ventilatory efficiency in patients with heart failure (HF) or chronic coronary syndromes (CCS). Exercise inefficient ventilation predicts disease progression and mortality in patients with cardiovascular diseases. In healthy people, improved ventilatory efficiency with nasal compared to oral breathing was found. Four study groups were recruited: Patients with HF, patients with CCS, old (age≥45 years) and young (age 20-40 years) healthy control subjects. After a 3-min warm-up, measurements of 5 min with once nasal and once oral breathing were performed in randomized order at 50% peak power on cycle ergometer. Ventilation and gas exchange parameters measured with spiroergometry were analysed by Wilcoxon paired-sample tests and linear mixed models adjusted for sex, height, weight and test order. Groups comprised 15 HF, CCS, and young control and 12 old control. Ventilation/carbon dioxide production ( / CO), ventilation ( ), breathing frequency (f), and end-tidal oxygen partial pressure (PO) were significantly lower and tidal volume and end-tidal carbon dioxide partial pressure (PCO) significantly higher during nasal compared to oral breathing in all groups, with large effect sizes for most parameters. For patients with HF, median / CO was 35% lower, f 26% lower, and PCO 10% higher with nasal compared to oral breathing, respectively. Exercise oscillatory ventilation (EOV) was present in 6 patients and markedly reduced with nasal breathing. Nasal breathing during submaximal exercise significantly improved ventilatory efficiency and abnormal breathing patterns (rapid shallow breathing and EOV) in 80% of our patients with HF and CCS.
评估鼻呼吸是否能改善心力衰竭（HF）或慢性冠状动脉综合征（CCS）患者的运动通气效率。运动通气效率低下可预测心血管疾病患者的疾病进展和死亡率。在健康人群中，已发现与口呼吸相比，鼻呼吸可提高通气效率。招募了四个研究组：HF患者、CCS患者、老年（年龄≥45岁）和年轻（年龄20 - 40岁）健康对照受试者。在进行3分钟热身运动后，在功率自行车上以50%峰值功率按随机顺序进行5分钟的测量，分别进行一次鼻呼吸和一次口呼吸。使用肺功能仪测量的通气和气体交换参数通过Wilcoxon配对样本检验以及根据性别、身高、体重和测试顺序进行调整的线性混合模型进行分析。每组包括15名HF患者、CCS患者和年轻对照者以及12名老年对照者。在所有组中，与口呼吸相比，鼻呼吸时通气/二氧化碳产生量（ / CO）、通气量（ ）、呼吸频率（f）和呼气末氧分压（PO）显著降低，潮气量和呼气末二氧化碳分压（PCO）显著升高，大多数参数的效应量较大。对于HF患者，与口呼吸相比，鼻呼吸时 / CO中位数分别低35%，f低26%，PCO高10%。6例患者存在运动振荡通气（EOV），鼻呼吸时明显减轻。在次最大运动期间，鼻呼吸显著改善了80%的HF和CCS患者的通气效率以及异常呼吸模式（快速浅呼吸和EOV）。
