Effects of simulated altitude-induced hypoxia on exercise capacity in patients with chronic heart failure

Piergiuseppe Agostoni, Gaia Cattadori, Marco Guazzi, Maurizio Bussotti, Cristina Conca, Massimo Lomanto, Giancarlo Marenzi, Maurizio D. Guazzi

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Abstract

PURPOSE: Patients with stable heart failure often wish to spend time at altitudes above those of their residence. However, it is not known whether they can safely tolerate ascent to high altitudes or what its effects on work capacity may be. SUBJECTS AND METHODS: We studied 14 normal subjects and 38 patients with clinically stable heart failure, 12 of whom had normal workload [peak exercise oxygen consumption (VO2) greater than 20 mL/min/kg], 14 of whom had slightly diminished workload (peak VO2 20 to 15 mL/min/kg), and 12 of whom had markedly diminished workload (peak VO2 less than 15 mL/min/kg) at baseline. All performed cardiopulmonary exercise tests with inspired oxygen fractions equal to those at 92, 1,000, 1,500, 2,000, and 3,000 m, and maximum achieved work rates (mean ± SD) were measured. RESULTS: All subjects completed the trial; no test was interrupted because of arrhythmia, angina, or ischemia. Maximum work rate decreased in parallel with increasing simulated altitude. The percentage decrease was greater for patients with heart failure and was most marked among those with the lowest workload at baseline. Maximum achieved work rate declined by 3% ± 4% per 1,000 m in normal subjects, by 5% ± 3% (P <0.01) in patients with heart failure with normal workload, by 5% ± 4% (P <0.01) in patients with slightly diminished workload, and by 11% ± 5% (P <0.01 vs normal subjects and vs the other patients with heart failure) in patients with markedly reduced workload. CONCLUSION: Patients with stable heart failure who ascend to higher altitudes should expect to have a reduction in maximum physical activity in proportion to their exercise capacity at sea level. (C) 2000 by Excerpta Medica, Inc.

Original languageEnglish
Pages (from-to)450-455
Number of pages6
JournalAmerican Journal of Medicine
Volume109
Issue number6
DOIs
Publication statusPublished - Oct 15 2000

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Altitude Sickness
Workload
Heart Failure
Exercise
Exercise Test
Oxygen Consumption
Oceans and Seas
Cardiac Arrhythmias
Ischemia
Oxygen

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Effects of simulated altitude-induced hypoxia on exercise capacity in patients with chronic heart failure. / Agostoni, Piergiuseppe; Cattadori, Gaia; Guazzi, Marco; Bussotti, Maurizio; Conca, Cristina; Lomanto, Massimo; Marenzi, Giancarlo; Guazzi, Maurizio D.

In: American Journal of Medicine, Vol. 109, No. 6, 15.10.2000, p. 450-455.

Research output: Contribution to journalArticle

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abstract = "PURPOSE: Patients with stable heart failure often wish to spend time at altitudes above those of their residence. However, it is not known whether they can safely tolerate ascent to high altitudes or what its effects on work capacity may be. SUBJECTS AND METHODS: We studied 14 normal subjects and 38 patients with clinically stable heart failure, 12 of whom had normal workload [peak exercise oxygen consumption (VO2) greater than 20 mL/min/kg], 14 of whom had slightly diminished workload (peak VO2 20 to 15 mL/min/kg), and 12 of whom had markedly diminished workload (peak VO2 less than 15 mL/min/kg) at baseline. All performed cardiopulmonary exercise tests with inspired oxygen fractions equal to those at 92, 1,000, 1,500, 2,000, and 3,000 m, and maximum achieved work rates (mean ± SD) were measured. RESULTS: All subjects completed the trial; no test was interrupted because of arrhythmia, angina, or ischemia. Maximum work rate decreased in parallel with increasing simulated altitude. The percentage decrease was greater for patients with heart failure and was most marked among those with the lowest workload at baseline. Maximum achieved work rate declined by 3{\%} ± 4{\%} per 1,000 m in normal subjects, by 5{\%} ± 3{\%} (P <0.01) in patients with heart failure with normal workload, by 5{\%} ± 4{\%} (P <0.01) in patients with slightly diminished workload, and by 11{\%} ± 5{\%} (P <0.01 vs normal subjects and vs the other patients with heart failure) in patients with markedly reduced workload. CONCLUSION: Patients with stable heart failure who ascend to higher altitudes should expect to have a reduction in maximum physical activity in proportion to their exercise capacity at sea level. (C) 2000 by Excerpta Medica, Inc.",
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T1 - Effects of simulated altitude-induced hypoxia on exercise capacity in patients with chronic heart failure

AU - Agostoni, Piergiuseppe

AU - Cattadori, Gaia

AU - Guazzi, Marco

AU - Bussotti, Maurizio

AU - Conca, Cristina

AU - Lomanto, Massimo

AU - Marenzi, Giancarlo

AU - Guazzi, Maurizio D.

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Y1 - 2000/10/15

N2 - PURPOSE: Patients with stable heart failure often wish to spend time at altitudes above those of their residence. However, it is not known whether they can safely tolerate ascent to high altitudes or what its effects on work capacity may be. SUBJECTS AND METHODS: We studied 14 normal subjects and 38 patients with clinically stable heart failure, 12 of whom had normal workload [peak exercise oxygen consumption (VO2) greater than 20 mL/min/kg], 14 of whom had slightly diminished workload (peak VO2 20 to 15 mL/min/kg), and 12 of whom had markedly diminished workload (peak VO2 less than 15 mL/min/kg) at baseline. All performed cardiopulmonary exercise tests with inspired oxygen fractions equal to those at 92, 1,000, 1,500, 2,000, and 3,000 m, and maximum achieved work rates (mean ± SD) were measured. RESULTS: All subjects completed the trial; no test was interrupted because of arrhythmia, angina, or ischemia. Maximum work rate decreased in parallel with increasing simulated altitude. The percentage decrease was greater for patients with heart failure and was most marked among those with the lowest workload at baseline. Maximum achieved work rate declined by 3% ± 4% per 1,000 m in normal subjects, by 5% ± 3% (P <0.01) in patients with heart failure with normal workload, by 5% ± 4% (P <0.01) in patients with slightly diminished workload, and by 11% ± 5% (P <0.01 vs normal subjects and vs the other patients with heart failure) in patients with markedly reduced workload. CONCLUSION: Patients with stable heart failure who ascend to higher altitudes should expect to have a reduction in maximum physical activity in proportion to their exercise capacity at sea level. (C) 2000 by Excerpta Medica, Inc.

AB - PURPOSE: Patients with stable heart failure often wish to spend time at altitudes above those of their residence. However, it is not known whether they can safely tolerate ascent to high altitudes or what its effects on work capacity may be. SUBJECTS AND METHODS: We studied 14 normal subjects and 38 patients with clinically stable heart failure, 12 of whom had normal workload [peak exercise oxygen consumption (VO2) greater than 20 mL/min/kg], 14 of whom had slightly diminished workload (peak VO2 20 to 15 mL/min/kg), and 12 of whom had markedly diminished workload (peak VO2 less than 15 mL/min/kg) at baseline. All performed cardiopulmonary exercise tests with inspired oxygen fractions equal to those at 92, 1,000, 1,500, 2,000, and 3,000 m, and maximum achieved work rates (mean ± SD) were measured. RESULTS: All subjects completed the trial; no test was interrupted because of arrhythmia, angina, or ischemia. Maximum work rate decreased in parallel with increasing simulated altitude. The percentage decrease was greater for patients with heart failure and was most marked among those with the lowest workload at baseline. Maximum achieved work rate declined by 3% ± 4% per 1,000 m in normal subjects, by 5% ± 3% (P <0.01) in patients with heart failure with normal workload, by 5% ± 4% (P <0.01) in patients with slightly diminished workload, and by 11% ± 5% (P <0.01 vs normal subjects and vs the other patients with heart failure) in patients with markedly reduced workload. CONCLUSION: Patients with stable heart failure who ascend to higher altitudes should expect to have a reduction in maximum physical activity in proportion to their exercise capacity at sea level. (C) 2000 by Excerpta Medica, Inc.

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