Karsten Marlus, Palermo Pietro, Mattavelli Irene, Contini Mauro, Mapelli Massimo, Vignati Carlo, Apostolo Anna, Salvioni Elisabetta, Pezzuto Beatrice, Piotti Arianna, Campodonico Jeness, Magrì Damiano, Agostoni Piergiuseppe
Research Group on Cardiovascular Health and Exercise (GEPCardio), Physiotherapy Graduate Program, Department of Physiotherapy, Universidade do Estado de Santa Catarina (UDESC), Florianopolis, SC, Brazil; Centro Cardiologico Monzino, IRCCs, Milan, Italy.
Centro Cardiologico Monzino, IRCCs, Milan, Italy.
Int J Cardiol. 2025 Oct 15;437:133475. doi: 10.1016/j.ijcard.2025.133475. Epub 2025 Jun 5.
Exercise oscillatory ventilation (EOV) is a negative prognostic marker in patients with heart failure (HF). EOV can either disappear (D-EOV) or persist (P-EOV) during exercise, with each showing different clinical implications. The relationship between respiratory muscle weakness and EOV persistence is not well understood, and its impact on exercise performance and muscle function in HF patients needs further exploration.
This study included 98 clinically stable HF patients with reduced left ventricular ejection fraction (LVEF), all undergoing cardiopulmonary exercise testing (CPET) and measurement of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). EOV was classified as D-EOV or P-EOV, and the temporal behavior of EOV was analyzed in relation to inspiratory muscle weakness (IMW), using standard ERS criteria.
Patients with P-EOV were older, with lower BMI, showed worse exercise performance, with lower peak workload (47 [38;59] vs. 67 [52;94] watts) and pVO (10.8 [9.3;12.7] vs. 13.4 [12.1;16.0] mL/kg/min). Respiratory muscle strength was weaker in P-EOV patients (MIP: 73.3 ± 25.6 vs. 93.4 ± 26.6 cmHO; MEP: 102.9 ± 40.9 vs. 131.8 ± 40.8 cmHO). A higher proportion of P-EOV patients had IMW (p < 0.05). P-EOV patients with IMW had worse exercise capacity, lower BMI and lower exercise performance (peak workload = 41.5 [36;52] vs. 63 [46;86] watts) than those with D-EOV and IMW.
EOV persistence is associated with worse exercise performance, respiratory muscle weakness, and potentially sarcopenia in HF patients.
运动性振荡通气（EOV）是心力衰竭（HF）患者的不良预后标志物。EOV在运动过程中可消失（D-EOV）或持续存在（P-EOV），每种情况都有不同的临床意义。呼吸肌无力与EOV持续存在之间的关系尚不清楚，其对HF患者运动能力和肌肉功能的影响有待进一步探索。
本研究纳入98例临床稳定、左心室射血分数（LVEF）降低的HF患者，均接受心肺运动试验（CPET）以及最大吸气压（MIP）和最大呼气压（MEP）测量。EOV分为D-EOV或P-EOV，并根据欧洲呼吸学会（ERS）标准分析EOV的时间行为与吸气肌无力（IMW）的关系。
P-EOV患者年龄较大，体重指数较低，运动能力较差，峰值负荷较低（47[38；59]瓦对67[52；94]瓦）和峰值摄氧量较低（10.8[9.3；12.7]毫升/千克/分钟对13.4[12.1；16.0]毫升/千克/分钟）。P-EOV患者的呼吸肌力量较弱（MIP：73.3±25.6对93.4±26.6厘米水柱；MEP：102.9±40.9对131.8±40.8厘米水柱）。P-EOV患者中IMW的比例更高（p<0.05）。与D-EOV和IMW患者相比，有IMW的P-EOV患者运动能力更差，体重指数更低，运动表现更差（峰值负荷=41.5[36；52]瓦对63[46；86]瓦）。
EOV持续存在与HF患者运动能力较差、呼吸肌无力以及可能的肌肉减少症相关。
