TY - JOUR
T1 - How Patients with Heart Failure Perform Daily Life Activities: An Innate Energy-Saving Strategy
AU - Mapelli, Massimo
AU - Salvioni, Elisabetta
AU - Bonomi, Alice
AU - Gugliandolo, Paola
AU - De Martino, Fabiana
AU - Vignati, Carlo
AU - Berna, Giovanni
AU - Agostoni, Piergiuseppe
N1 - Publisher Copyright:
© 2020 American Heart Association, Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background: Cardiopulmonary exercise test and 6-minute walking test are frequently used tools to evaluate physical performance in heart failure (HF), but they do neither represent activities of daily living (ADLs) nor fully reproduce patients' symptoms. We assessed differences in task oxygen uptake, both as absolute value and as percentage of peak oxygen consumption (peakVO2), ventilation efficiency (VE/VCO2 ratio), and dyspnea intensity (Borg scale) in HF and healthy subjects during standard ADLs and other common physical actions. Methods: Healthy and HF subjects (ejection fraction <45%, stable conditions) underwent cardiopulmonary exercise test. All of them, carrying a wearable metabolic cart, performed a 6-minute walking test, two 4-minute treadmill exercises (at 2 and 3 km/h), and ADLs: ADL1 (getting dressed), ADL2 (folding 8 towels), ADL3 (putting away 6 bottles), ADL4 (making a bed), ADL5 (sweeping the floor for 4 minutes), ADL6 (climbing 1 flight of stairs carrying a load). Results: Sixty patients with HF (age 65.2±12.1 years; ejection fraction 30.4±6.7%, peakVO2 14.2±4.0 mL/[min·kg]) and 40 healthy volunteers (58.9±8.2 years, peakVO2 28.1±7.4 mL/[min·kg]) were enrolled. For each exercise, patients showed higher VE/VCO2 ratio, percentage of peakVO2, and Borg scale value than controls, while absolute values of task oxygen uptake and exercise duration were lower and higher, respectively, in all activities, except for treadmill (fixed execution time and intensity). Differently from Borg Scale data, metabolic values and exercise time length changed in parallel with HF severity, except for ADL duration in very short (ADL3) and composite (ADL1) activities. Borg scale values correlated with percentage of peakVO2. Conclusions: During ADLs, patients self-regulated activities in parallel with HF severity by decreasing intensity (VO2) and prolonging the effort.
AB - Background: Cardiopulmonary exercise test and 6-minute walking test are frequently used tools to evaluate physical performance in heart failure (HF), but they do neither represent activities of daily living (ADLs) nor fully reproduce patients' symptoms. We assessed differences in task oxygen uptake, both as absolute value and as percentage of peak oxygen consumption (peakVO2), ventilation efficiency (VE/VCO2 ratio), and dyspnea intensity (Borg scale) in HF and healthy subjects during standard ADLs and other common physical actions. Methods: Healthy and HF subjects (ejection fraction <45%, stable conditions) underwent cardiopulmonary exercise test. All of them, carrying a wearable metabolic cart, performed a 6-minute walking test, two 4-minute treadmill exercises (at 2 and 3 km/h), and ADLs: ADL1 (getting dressed), ADL2 (folding 8 towels), ADL3 (putting away 6 bottles), ADL4 (making a bed), ADL5 (sweeping the floor for 4 minutes), ADL6 (climbing 1 flight of stairs carrying a load). Results: Sixty patients with HF (age 65.2±12.1 years; ejection fraction 30.4±6.7%, peakVO2 14.2±4.0 mL/[min·kg]) and 40 healthy volunteers (58.9±8.2 years, peakVO2 28.1±7.4 mL/[min·kg]) were enrolled. For each exercise, patients showed higher VE/VCO2 ratio, percentage of peakVO2, and Borg scale value than controls, while absolute values of task oxygen uptake and exercise duration were lower and higher, respectively, in all activities, except for treadmill (fixed execution time and intensity). Differently from Borg Scale data, metabolic values and exercise time length changed in parallel with HF severity, except for ADL duration in very short (ADL3) and composite (ADL1) activities. Borg scale values correlated with percentage of peakVO2. Conclusions: During ADLs, patients self-regulated activities in parallel with HF severity by decreasing intensity (VO2) and prolonging the effort.
KW - activities of daily living
KW - dyspnea
KW - exercise
KW - heart failure
KW - oxygen consumption
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U2 - 10.1161/CIRCHEARTFAILURE.120.007503
DO - 10.1161/CIRCHEARTFAILURE.120.007503
M3 - Article
C2 - 33201750
AN - SCOPUS:85096348304
SP - 561
EP - 573
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
SN - 1941-3297
M1 - 7503
ER -