Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study
BackgroundIn patients with chronic coronary syndromes (CCS), increased ventilation/carbon dioxide production (V̇E/V̇CO2) slope has been found to predict disease progression and mortality, similarly to patients with heart failure (HF); however, increased chemosensitivity, a well-established predictor...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2024.1509421/full |
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| author | Prisca Eser Dominic Käesermann Pietro Calamai Anja Kalberer Laura Stütz Sarina Huber James Duffin Matthias Wilhelm |
| author_facet | Prisca Eser Dominic Käesermann Pietro Calamai Anja Kalberer Laura Stütz Sarina Huber James Duffin Matthias Wilhelm |
| author_sort | Prisca Eser |
| collection | DOAJ |
| description | BackgroundIn patients with chronic coronary syndromes (CCS), increased ventilation/carbon dioxide production (V̇E/V̇CO2) slope has been found to predict disease progression and mortality, similarly to patients with heart failure (HF); however, increased chemosensitivity, a well-established predictor for mortality in patients with HF, has rarely been assessed in patients with CCS.MethodPatients with CCS, HF with reduced ejection fraction (EF < 50%), healthy controls (45+ years), and young healthy adults (<35 years) were recruited. For patients, a V̇E/V̇CO2 slope ≥36 was an inclusion criterion. The Duffin rebreathing method was used to determine the resting end-expiratory partial pressure of carbon dioxide (PETCO2), ventilatory recruitment threshold (VRT), and slope (sensitivity) during a hyperoxic (150 mmHg O2) and hypoxic (50 mmHg O2) rebreathing test to determine the central and peripheral chemosensitivity.ResultsIn patients with CCS, HF, controls, and young healthy adults, median V̇E/V̇CO2 slopes were 40.2, 41.3, 30.5, and 28.0, respectively. Both patient groups had similarly reduced hyperoxic VRT (at PETCO2 42.1 and 43.2 mmHg) compared to 46.0 and 48.8 mmHg in the control and young healthy adults. Neither hypoxic VRT nor hyper- or hypoxic slopes were significantly different in patients compared to controls. Both patient groups had lower resting PETCO2 than controls, but only patients with HF had increased breathing frequency and rapid shallow breathing at rest.ConclusionIn patients with HF and/or CCS and excess ventilation, central chemoreflex VRT was reduced independently of the presence of HF. Low VRTs were related to resting excess ventilation in patients with CCS or HF; however, rapid shallow breathing at peak exercise was present only in patients with HF.Clinical trial registration numberNCT05057884. |
| format | Article |
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| institution | Kabale University |
| issn | 1664-042X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj-art-1aa1a459f9ae46ecadc72130ce9f7cb82025-01-22T07:12:45ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-01-011510.3389/fphys.2024.15094211509421Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control studyPrisca Eser0Dominic Käesermann1Pietro Calamai2Anja Kalberer3Laura Stütz4Sarina Huber5James Duffin6Matthias Wilhelm7Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandDepartment of Anesthesia and Pain Management, University of Toronto, Toronto, ON, CanadaCentre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandBackgroundIn patients with chronic coronary syndromes (CCS), increased ventilation/carbon dioxide production (V̇E/V̇CO2) slope has been found to predict disease progression and mortality, similarly to patients with heart failure (HF); however, increased chemosensitivity, a well-established predictor for mortality in patients with HF, has rarely been assessed in patients with CCS.MethodPatients with CCS, HF with reduced ejection fraction (EF < 50%), healthy controls (45+ years), and young healthy adults (<35 years) were recruited. For patients, a V̇E/V̇CO2 slope ≥36 was an inclusion criterion. The Duffin rebreathing method was used to determine the resting end-expiratory partial pressure of carbon dioxide (PETCO2), ventilatory recruitment threshold (VRT), and slope (sensitivity) during a hyperoxic (150 mmHg O2) and hypoxic (50 mmHg O2) rebreathing test to determine the central and peripheral chemosensitivity.ResultsIn patients with CCS, HF, controls, and young healthy adults, median V̇E/V̇CO2 slopes were 40.2, 41.3, 30.5, and 28.0, respectively. Both patient groups had similarly reduced hyperoxic VRT (at PETCO2 42.1 and 43.2 mmHg) compared to 46.0 and 48.8 mmHg in the control and young healthy adults. Neither hypoxic VRT nor hyper- or hypoxic slopes were significantly different in patients compared to controls. Both patient groups had lower resting PETCO2 than controls, but only patients with HF had increased breathing frequency and rapid shallow breathing at rest.ConclusionIn patients with HF and/or CCS and excess ventilation, central chemoreflex VRT was reduced independently of the presence of HF. Low VRTs were related to resting excess ventilation in patients with CCS or HF; however, rapid shallow breathing at peak exercise was present only in patients with HF.Clinical trial registration numberNCT05057884.https://www.frontiersin.org/articles/10.3389/fphys.2024.1509421/fullinefficient ventilationcentral chemosensitivitycardiopulmonary exercise testingresting ventilationchronic coronary syndrome |
| spellingShingle | Prisca Eser Dominic Käesermann Pietro Calamai Anja Kalberer Laura Stütz Sarina Huber James Duffin Matthias Wilhelm Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study Frontiers in Physiology inefficient ventilation central chemosensitivity cardiopulmonary exercise testing resting ventilation chronic coronary syndrome |
| title | Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study |
| title_full | Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study |
| title_fullStr | Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study |
| title_full_unstemmed | Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study |
| title_short | Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure: a case–control study |
| title_sort | excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failure a case control study |
| topic | inefficient ventilation central chemosensitivity cardiopulmonary exercise testing resting ventilation chronic coronary syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2024.1509421/full |
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