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Modulation of ventilatory reflex control by cardiac resynchronization therapy.
- Source :
-
Journal of cardiac failure [J Card Fail] 2015 May; Vol. 21 (5), pp. 367-373. Date of Electronic Publication: 2015 Jan 08. - Publication Year :
- 2015
-
Abstract
- Background: Heart failure (HF) is characterized by heightened sensitivities of the CO2 chemoreflex and the ergoreflex which promote increased ventilatory drive manifested as increased minute ventilation per volume of expired CO2 (VE/VCO2). The aims of this study were to evaluate the effects of cardiac resynchronization therapy (CRT) on carbon dioxide (CO2) chemosensitivity and the arterial CO2 setpoint.<br />Methods and Results: Consecutive HF patients (n = 35) who underwent clinically indicated CRT were investigated by means of cardiopulmonary exercise testing and CO2 chemosensitivity evaluation with the use of a rebreathe method before and 4-6 months after CRT. Pre- and post-CRT measures were compared with the use of either paired t test or Wilcoxon test. Decreased peak VE/VCO2 (44 ± 10 vs 40 ± 8; P < .01), CO2 chemosensitivity (2.2 ± 1.1 vs 1.7 ± 0.8 L min(-1) mm Hg(-1); P = .04), and increased peak end-tidal CO2 (29 ± 5 vs 31 ± 5 mm Hg; P < .01) were also observed after CRT. Multivariate analysis adjusted for age and sex showed the decrease of peak VE/VCO2 from before to after CRT to be most strongly associated with the increase of peak end-tidal CO2 (β = -0.84; F = 21.5; P < .0001).<br />Conclusions: Decrease of VE/VCO2 after CRT is associated with decreased CO2 chemosensitivity and increase of the arterial CO2 setpoint, which is consistent with decreased activation of both the CO2 chemoreflex and the ergoreflex.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Blood Gas Analysis methods
Carbon Dioxide metabolism
Exercise Test methods
Female
Follow-Up Studies
Heart Failure diagnosis
Heart Failure metabolism
Humans
Male
Middle Aged
Oxygen Consumption physiology
Cardiac Resynchronization Therapy methods
Heart Failure therapy
Pulmonary Ventilation physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8414
- Volume :
- 21
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of cardiac failure
- Publication Type :
- Academic Journal
- Accession number :
- 25576681
- Full Text :
- https://doi.org/10.1016/j.cardfail.2014.12.013