Exercise ventilation inefficiency in heart failure: Pathophysiological and clinical significance

Gabriele Tumminello, Marco Guazzi, Patrizio Lancellotti, Luc A. Piérard

Research output: Contribution to journalArticle

Abstract

Heart failure (HF) is a complex syndrome characterized by myocardial dysfunction and a poor prognosis. Among multiple markers of severity, an exercise ventilation inefficiency has important clinical and prognostic value. The pathophysiology determining exercise ventilatory inefficiency is complex and not definitively clarified. Three different mechanisms have been identified: (i) increased dead space, (ii) early occurrence of lactic acidosis, and (iii) abnormal chemoreflex and/or metaboreflex activity. Besides its prognostic value, abnormal ventilation can be influenced by pharmacological and non-pharmacological therapies such as β-blockers, selective cyclic 3′-5′ guanosine monosphosphate phosphodiesterase inhibitors, physical training, and nocturnal continuous positive airway pressure. There is an increasing interest for the exercise periodic breathing, which is frequently associated with HF syndrome and has prognostic importance. The precise mechanisms sustaining exercise periodic breathing are not fully defined but ventilatory and metabo-haemodynamic hypotheses have been proposed.

Original languageEnglish
Pages (from-to)673-678
Number of pages6
JournalEuropean Heart Journal
Volume28
Issue number6
DOIs
Publication statusPublished - Mar 2007

Fingerprint

Breathing Exercises
Ventilation
Heart Failure
Lactic Acidosis
Continuous Positive Airway Pressure
Phosphodiesterase Inhibitors
Guanosine
Hemodynamics
Pharmacology
Therapeutics

Keywords

  • Exercise
  • Heart failure
  • Periodic breathing
  • Ventilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Exercise ventilation inefficiency in heart failure : Pathophysiological and clinical significance. / Tumminello, Gabriele; Guazzi, Marco; Lancellotti, Patrizio; Piérard, Luc A.

In: European Heart Journal, Vol. 28, No. 6, 03.2007, p. 673-678.

Research output: Contribution to journalArticle

Tumminello, Gabriele ; Guazzi, Marco ; Lancellotti, Patrizio ; Piérard, Luc A. / Exercise ventilation inefficiency in heart failure : Pathophysiological and clinical significance. In: European Heart Journal. 2007 ; Vol. 28, No. 6. pp. 673-678.
@article{5203b519d32e457b80d3f7a851fddba8,
title = "Exercise ventilation inefficiency in heart failure: Pathophysiological and clinical significance",
abstract = "Heart failure (HF) is a complex syndrome characterized by myocardial dysfunction and a poor prognosis. Among multiple markers of severity, an exercise ventilation inefficiency has important clinical and prognostic value. The pathophysiology determining exercise ventilatory inefficiency is complex and not definitively clarified. Three different mechanisms have been identified: (i) increased dead space, (ii) early occurrence of lactic acidosis, and (iii) abnormal chemoreflex and/or metaboreflex activity. Besides its prognostic value, abnormal ventilation can be influenced by pharmacological and non-pharmacological therapies such as β-blockers, selective cyclic 3′-5′ guanosine monosphosphate phosphodiesterase inhibitors, physical training, and nocturnal continuous positive airway pressure. There is an increasing interest for the exercise periodic breathing, which is frequently associated with HF syndrome and has prognostic importance. The precise mechanisms sustaining exercise periodic breathing are not fully defined but ventilatory and metabo-haemodynamic hypotheses have been proposed.",
keywords = "Exercise, Heart failure, Periodic breathing, Ventilation",
author = "Gabriele Tumminello and Marco Guazzi and Patrizio Lancellotti and Pi{\'e}rard, {Luc A.}",
year = "2007",
month = "3",
doi = "10.1093/eurheartj/ehl404",
language = "English",
volume = "28",
pages = "673--678",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Exercise ventilation inefficiency in heart failure

T2 - Pathophysiological and clinical significance

AU - Tumminello, Gabriele

AU - Guazzi, Marco

AU - Lancellotti, Patrizio

AU - Piérard, Luc A.

PY - 2007/3

Y1 - 2007/3

N2 - Heart failure (HF) is a complex syndrome characterized by myocardial dysfunction and a poor prognosis. Among multiple markers of severity, an exercise ventilation inefficiency has important clinical and prognostic value. The pathophysiology determining exercise ventilatory inefficiency is complex and not definitively clarified. Three different mechanisms have been identified: (i) increased dead space, (ii) early occurrence of lactic acidosis, and (iii) abnormal chemoreflex and/or metaboreflex activity. Besides its prognostic value, abnormal ventilation can be influenced by pharmacological and non-pharmacological therapies such as β-blockers, selective cyclic 3′-5′ guanosine monosphosphate phosphodiesterase inhibitors, physical training, and nocturnal continuous positive airway pressure. There is an increasing interest for the exercise periodic breathing, which is frequently associated with HF syndrome and has prognostic importance. The precise mechanisms sustaining exercise periodic breathing are not fully defined but ventilatory and metabo-haemodynamic hypotheses have been proposed.

AB - Heart failure (HF) is a complex syndrome characterized by myocardial dysfunction and a poor prognosis. Among multiple markers of severity, an exercise ventilation inefficiency has important clinical and prognostic value. The pathophysiology determining exercise ventilatory inefficiency is complex and not definitively clarified. Three different mechanisms have been identified: (i) increased dead space, (ii) early occurrence of lactic acidosis, and (iii) abnormal chemoreflex and/or metaboreflex activity. Besides its prognostic value, abnormal ventilation can be influenced by pharmacological and non-pharmacological therapies such as β-blockers, selective cyclic 3′-5′ guanosine monosphosphate phosphodiesterase inhibitors, physical training, and nocturnal continuous positive airway pressure. There is an increasing interest for the exercise periodic breathing, which is frequently associated with HF syndrome and has prognostic importance. The precise mechanisms sustaining exercise periodic breathing are not fully defined but ventilatory and metabo-haemodynamic hypotheses have been proposed.

KW - Exercise

KW - Heart failure

KW - Periodic breathing

KW - Ventilation

UR - http://www.scopus.com/inward/record.url?scp=33947312302&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947312302&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehl404

DO - 10.1093/eurheartj/ehl404

M3 - Article

C2 - 17124197

AN - SCOPUS:33947312302

VL - 28

SP - 673

EP - 678

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 6

ER -