Ultrafiltration in moderate heart failure: Exercise oxygen uptake as a predictor of the clinical benefits

Research output: Contribution to journalArticle

Abstract

Objective: Ultra filtration (UF) can improve the exercise performance of patients with moderate congestive heart failure (CHF). Our aim was to define the starting levels of performance below which UF is beneficial. Patients and method: We studied 26 patients in 2 to 3 NYHA class, whose clinical condition was stable, left ventricle ejection fraction (echocardiography) was 2) was ≥14 mL/min/kg. They underwent a single extracorporeal UF (about 600 mL of ultrafiltrate per hour). Before that, we evaluated pulmonary function (PFT), functional capacity (cardiopulmonary exercise test [CPX]), cardiac index, left ventricle ejection fraction, ventricular filling pressures, and plasma norepinephrine at rest. The PFTs and CPXs were repeated 3 months after UF. Results: Sixteen patients had a rise of peak exercise VO2 >1 mL/min/kg at the 3-month evaluation (group A, ultrafiltrate=2,040±241 mL) and 10 did not (group B, ultrafiltrate= 1,870 ± 169 mL). Forced expiratory volume (1 s), maximal voluntary ventilation, and vital capacity were lower in group A than in group B and improved after UF only in group A. Before UF, VO2 at peak exercise and at anaerobic threshold (15.5 ± 0.4 mL/min/kg and 11.0 ± 0.5, respectively) was also lower in group A than in group B (21.2 ± 0.7 mL/min/kg and 14.8 ± 0.9, p2 was >18.5 mL/min/kg (group B) had no increase in this variable. No significant group differences were detected regarding norepinephrine, left ventricular ejection fraction, and hemodynamic parameters at rest. Conclusion: In patients with moderate CHF undergoing UF, exercise capacity improvement is inversely related to the pre- UF level of physical performance and pulmonary function; VO2 at peak exercise seems useful for identification of patients not benefiting from the procedure.

Original languageEnglish
Pages (from-to)94-98
Number of pages5
JournalChest
Volume108
Issue number1
Publication statusPublished - 1995

Fingerprint

Ultrafiltration
Heart Failure
Exercise
Oxygen
Heart Ventricles
Norepinephrine
Maximal Voluntary Ventilation
Anaerobic Threshold
Lung
Vital Capacity
Forced Expiratory Volume
Ventricular Pressure
Exercise Test
Stroke Volume
Echocardiography
Hemodynamics

Keywords

  • heart failure
  • lung water
  • oxygen uptake
  • ultrafiltration

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{e8929f6b02a14511a1a99affce7b666d,
title = "Ultrafiltration in moderate heart failure: Exercise oxygen uptake as a predictor of the clinical benefits",
abstract = "Objective: Ultra filtration (UF) can improve the exercise performance of patients with moderate congestive heart failure (CHF). Our aim was to define the starting levels of performance below which UF is beneficial. Patients and method: We studied 26 patients in 2 to 3 NYHA class, whose clinical condition was stable, left ventricle ejection fraction (echocardiography) was 2) was ≥14 mL/min/kg. They underwent a single extracorporeal UF (about 600 mL of ultrafiltrate per hour). Before that, we evaluated pulmonary function (PFT), functional capacity (cardiopulmonary exercise test [CPX]), cardiac index, left ventricle ejection fraction, ventricular filling pressures, and plasma norepinephrine at rest. The PFTs and CPXs were repeated 3 months after UF. Results: Sixteen patients had a rise of peak exercise VO2 >1 mL/min/kg at the 3-month evaluation (group A, ultrafiltrate=2,040±241 mL) and 10 did not (group B, ultrafiltrate= 1,870 ± 169 mL). Forced expiratory volume (1 s), maximal voluntary ventilation, and vital capacity were lower in group A than in group B and improved after UF only in group A. Before UF, VO2 at peak exercise and at anaerobic threshold (15.5 ± 0.4 mL/min/kg and 11.0 ± 0.5, respectively) was also lower in group A than in group B (21.2 ± 0.7 mL/min/kg and 14.8 ± 0.9, p2 was >18.5 mL/min/kg (group B) had no increase in this variable. No significant group differences were detected regarding norepinephrine, left ventricular ejection fraction, and hemodynamic parameters at rest. Conclusion: In patients with moderate CHF undergoing UF, exercise capacity improvement is inversely related to the pre- UF level of physical performance and pulmonary function; VO2 at peak exercise seems useful for identification of patients not benefiting from the procedure.",
keywords = "heart failure, lung water, oxygen uptake, ultrafiltration",
author = "Marenzi, {G. C.} and G. Lauri and M. Guazzi and Perego, {G. B.} and Agostoni, {P. G.}",
year = "1995",
language = "English",
volume = "108",
pages = "94--98",
journal = "Chest",
issn = "0012-3692",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Ultrafiltration in moderate heart failure

T2 - Exercise oxygen uptake as a predictor of the clinical benefits

AU - Marenzi, G. C.

AU - Lauri, G.

AU - Guazzi, M.

AU - Perego, G. B.

AU - Agostoni, P. G.

PY - 1995

Y1 - 1995

N2 - Objective: Ultra filtration (UF) can improve the exercise performance of patients with moderate congestive heart failure (CHF). Our aim was to define the starting levels of performance below which UF is beneficial. Patients and method: We studied 26 patients in 2 to 3 NYHA class, whose clinical condition was stable, left ventricle ejection fraction (echocardiography) was 2) was ≥14 mL/min/kg. They underwent a single extracorporeal UF (about 600 mL of ultrafiltrate per hour). Before that, we evaluated pulmonary function (PFT), functional capacity (cardiopulmonary exercise test [CPX]), cardiac index, left ventricle ejection fraction, ventricular filling pressures, and plasma norepinephrine at rest. The PFTs and CPXs were repeated 3 months after UF. Results: Sixteen patients had a rise of peak exercise VO2 >1 mL/min/kg at the 3-month evaluation (group A, ultrafiltrate=2,040±241 mL) and 10 did not (group B, ultrafiltrate= 1,870 ± 169 mL). Forced expiratory volume (1 s), maximal voluntary ventilation, and vital capacity were lower in group A than in group B and improved after UF only in group A. Before UF, VO2 at peak exercise and at anaerobic threshold (15.5 ± 0.4 mL/min/kg and 11.0 ± 0.5, respectively) was also lower in group A than in group B (21.2 ± 0.7 mL/min/kg and 14.8 ± 0.9, p2 was >18.5 mL/min/kg (group B) had no increase in this variable. No significant group differences were detected regarding norepinephrine, left ventricular ejection fraction, and hemodynamic parameters at rest. Conclusion: In patients with moderate CHF undergoing UF, exercise capacity improvement is inversely related to the pre- UF level of physical performance and pulmonary function; VO2 at peak exercise seems useful for identification of patients not benefiting from the procedure.

AB - Objective: Ultra filtration (UF) can improve the exercise performance of patients with moderate congestive heart failure (CHF). Our aim was to define the starting levels of performance below which UF is beneficial. Patients and method: We studied 26 patients in 2 to 3 NYHA class, whose clinical condition was stable, left ventricle ejection fraction (echocardiography) was 2) was ≥14 mL/min/kg. They underwent a single extracorporeal UF (about 600 mL of ultrafiltrate per hour). Before that, we evaluated pulmonary function (PFT), functional capacity (cardiopulmonary exercise test [CPX]), cardiac index, left ventricle ejection fraction, ventricular filling pressures, and plasma norepinephrine at rest. The PFTs and CPXs were repeated 3 months after UF. Results: Sixteen patients had a rise of peak exercise VO2 >1 mL/min/kg at the 3-month evaluation (group A, ultrafiltrate=2,040±241 mL) and 10 did not (group B, ultrafiltrate= 1,870 ± 169 mL). Forced expiratory volume (1 s), maximal voluntary ventilation, and vital capacity were lower in group A than in group B and improved after UF only in group A. Before UF, VO2 at peak exercise and at anaerobic threshold (15.5 ± 0.4 mL/min/kg and 11.0 ± 0.5, respectively) was also lower in group A than in group B (21.2 ± 0.7 mL/min/kg and 14.8 ± 0.9, p2 was >18.5 mL/min/kg (group B) had no increase in this variable. No significant group differences were detected regarding norepinephrine, left ventricular ejection fraction, and hemodynamic parameters at rest. Conclusion: In patients with moderate CHF undergoing UF, exercise capacity improvement is inversely related to the pre- UF level of physical performance and pulmonary function; VO2 at peak exercise seems useful for identification of patients not benefiting from the procedure.

KW - heart failure

KW - lung water

KW - oxygen uptake

KW - ultrafiltration

UR - http://www.scopus.com/inward/record.url?scp=0029068190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029068190&partnerID=8YFLogxK

M3 - Article

C2 - 7607000

AN - SCOPUS:0029068190

VL - 108

SP - 94

EP - 98

JO - Chest

JF - Chest

SN - 0012-3692

IS - 1

ER -