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Ventilatory Limitation in Patients with HFpEF and Obesity: The Balance Between Increased Ventilatory Demand vs. Reduced Ventilatory Capacity

Authors :
T. Babb
B. Balmain
A. Tomlinson
C. Hearon
D. Wakeham
L. Hynan
B. Levine
J. MacNamara
S. Sarma
Source :
Physiology. 38
Publication Year :
2023
Publisher :
American Physiological Society, 2023.

Abstract

Study Objective: Patients with heart failure with preserved ejection fraction (HFpEF) have an increased ventilatory demand during exertion. Whether ventilatory capacity can meet this increased demand is unknown, especially in those with obesity. Hypothesis: We hypothesized that ventilatory capacity would be reduced in patients with HFpEF due to age- and obesity-related mechanical ventilatory constraints. Methodology: Body composition (DEXA) and pulmonary function were measured in 20 patients with invasively confirmed HFpEF (69±6yr; 9M/11W). Cardiorespiratory responses, breathing mechanics, and arterial blood gases were measured at rest, during exercise at 20 W, and at peak exercise. Based upon inspection of resting forced vital capacity (FVC, L) values, the patients were grouped into those with an FVC3.8L (n=8; 7M/1W). Differences between the two groups were compared using independent t-tests. Comparisons were not made between conditions (rest, 20W, & peak exercise). Results: Percent body fat was greater in the FVCE/V̇CO2) was equally elevated in both groups at rest and during exercise. FVC was 2 L less in the FVC50% VT at peak exercise). End inspiratory lung volume (L) approached 90% of total lung capacity in both groups, thus VT (%FVC) expansion was limited in both groups. The FVCE (L/min) enough to lower arterial CO2 at peak exercise as much as the FVC>3.8L group (40±4 vs 35±3; p2 (%predicted) was approximately 22% less (p This research was supported by the National Institutes of Health (1P01HL137630), King Foundation, Cain Foundation, and Texas Health Presbyterian Hospital Dallas. B.N. Balmain is supported by an American Heart Association Fellowship (grant number: 826064). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Subjects

Subjects :
Physiology

Details

ISSN :
15489221 and 15489213
Volume :
38
Database :
OpenAIRE
Journal :
Physiology
Accession number :
edsair.doi...........0fa0ba2608ab4d25a060dc258d91c894
Full Text :
https://doi.org/10.1152/physiol.2023.38.s1.5728211