Prognostic Comparison of the Minute Ventilation/Carbon Dioxide Production Ratio and Slope in Patients with Heart Failure

Heart Drug ◽  
2004 ◽  
Vol 4 (3) ◽  
pp. 133-139 ◽  
Author(s):  
Ross Arena ◽  
Jonathan Myers ◽  
Syed Salman Aslam ◽  
Elsa B. Varughese ◽  
Mary Ann Peberdy
Keyword(s):  
Heart Failure ◽  
Carbon Dioxide ◽  
Minute Ventilation ◽  
Carbon Dioxide Production ◽  
Production Ratio ◽  
Patients With Heart Failure

scholarly journals Ventilation/carbon dioxide production ratio in early exercise predicts poor functional capacity in congestive heart failure.

Heart ◽  
1996 ◽  
Vol 76 (5) ◽  
pp. 393-396 ◽  
Author(s):  
R. V. Milani ◽  
M. R. Mehra ◽  
T. K. Reddy ◽  
C. J. Lavie ◽  
H. O. Ventura
Keyword(s):  
Heart Failure ◽  
Carbon Dioxide ◽  
Congestive Heart Failure ◽  
Functional Capacity ◽  
Carbon Dioxide Production ◽  
Early Exercise ◽  
Production Ratio

scholarly journals Abnormalities of the Ventilatory Equivalent for Carbon Dioxide in Patients with Chronic Heart Failure

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lee Ingle ◽  
Rebecca Sloan ◽  
Sean Carroll ◽  
Kevin Goode ◽  
John G. Cleland ◽  
...  
Keyword(s):  
Heart Failure ◽  
Carbon Dioxide ◽  
Chronic Heart Failure ◽  
Oxygen Uptake ◽  
Minute Ventilation ◽  
Carbon Dioxide Production ◽  
Peak Oxygen Uptake ◽  
Healthy Controls ◽  
Ventilatory Equivalent ◽  
All Cause Mortality

Introduction. The relation between minute ventilation (VE) and carbon dioxide production (VCO2) can be characterised by the instantaneous ratio of ventilation to carbon dioxide production, the ventilatory equivalent for CO2(VEqCO2). We hypothesised that the time taken to achieve the lowest VEqCO2(time to VEqCO2 nadir) may be a prognostic marker in patients with chronic heart failure (CHF).Methods. Patients and healthy controls underwent a symptom-limited, cardiopulmonary exercise test (CPET) on a treadmill to volitional exhaustion.Results. 423 patients with CHF (mean age years; 80% males) and 78 healthy controls (62% males; age years) were recruited. Time to VEqCO2 nadir was shorter in patients than controls ( s versus  s; ). Univariable predictors of all-cause mortality included peak oxygen uptake (), VEqCO2nadir (), and time to VEqCO2nadir (). In an adjusted Cox multivariable proportional hazards model, peak oxygen uptake () and VEqCO2nadir () were the most significant independent predictors of all-cause mortality.Conclusion. The time to VEqCO2nadir was shorter in patients with CHF than in normal subjects and was a predictor of subsequent mortality.

scholarly journals Minute ventilation/carbon dioxide production in chronic heart failure

2021 ◽  
Vol 30 (159) ◽  
pp. 200141
Author(s):  
Piergiuseppe Agostoni ◽  
Susanna Sciomer ◽  
Pietro Palermo ◽  
Mauro Contini ◽  
Beatrice Pezzuto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Carbon Dioxide ◽  
Chronic Heart Failure ◽  
Dead Space ◽  
Minute Ventilation ◽  
Carbon Dioxide Production ◽  
Absolute Number ◽  
Prognostic Scores ◽  
And Gender ◽  
End Tidal

In chronic heart failure, minute ventilation (V′E) for a given carbon dioxide production (V′CO2) might be abnormally high during exercise due to increased dead space ventilation, lung stiffness, chemo- and metaboreflex sensitivity, early metabolic acidosis and abnormal pulmonary haemodynamics. The V′Eversus V′CO2 relationship, analysed either as ratio or as slope, enables us to evaluate the causes and entity of the V′E/perfusion mismatch. Moreover, the V′E axis intercept, i.e. when V′CO2 is extrapolated to 0, embeds information on exercise-induced dead space changes, while the analysis of end-tidal and arterial CO2 pressures provides knowledge about reflex activities. The V′Eversus V′CO2 relationship has a relevant prognostic power either alone or, better, when included within prognostic scores. The V′Eversus V′CO2 slope is reported as an absolute number with a recognised cut-off prognostic value of 35, except for specific diseases such as hypertrophic cardiomyopathy and idiopathic cardiomyopathy, where a lower cut-off has been suggested. However, nowadays, it is more appropriate to report V′Eversus V′CO2 slope as percentage of the predicted value, due to age and gender interferences. Relevant attention is needed in V′Eversus V′CO2 analysis in the presence of heart failure comorbidities. Finally, V′Eversus V′CO2 abnormalities are relevant targets for treatment in heart failure.

Relationship between the prognostic value of ventilatory efficiency and age in patients with heart failure

2018 ◽  
Vol 25 (7) ◽  
pp. 731-739 ◽  
Author(s):  
Yuko Kato ◽  
Shinya Suzuki ◽  
Tokuhisa Uejima ◽  
Hiroaki Semba ◽  
Osamu Nagayama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Minute Ventilation ◽  
Prognostic Significance ◽  
Cardiopulmonary Exercise Testing ◽  
Age Groups ◽  
Carbon Dioxide Production ◽  
Peak Oxygen Consumption ◽  
Ventilatory Efficiency ◽  
Patients With Heart Failure

Background Ventilatory efficiency decreases with age. This study aimed to investigate the prognostic significance and cut-off value of the minute ventilation/carbon dioxide production (VE/VCO2) slope according to age in patients with heart failure. Methods and results We analysed 1501 patients with heart failure from our observational cohort who performed maximal symptom-limited cardiopulmonary exercise testing and separated them into three age groups (≤55 years, 56–70 years and ≥71 years) in total and according to the three ejection fraction categories defined by European Society of Cardiology guidelines. The endpoint was set as heart failure events, hospitalisation for heart failure or death from heart failure. The VE/VCO2 slope increased with age. During the median follow-up period of 4 years, 141 heart failure (9%) events occurred. In total, univariate Cox analyses showed that the VE/VCO2 slope (cont.) was significantly related to heart failure events, while on multivariate analysis, the prognostic significance of the VE/VCO2 slope (cont.) was poor, accompanied by a significant interaction with age ( P < 0.0001). The cut-off value of the VE/VCO2 slope increased with the increase in age in not only the total but also the sub-ejection fraction categories. Multivariate analyses with a stepwise method adjusted for estimated glomerular filtration rate, peak oxygen consumption, atrial fibrillation and brain natriuretic peptide, showed that the predictive value of the binary VE/VCO2 slope separated by the cut-off value varied according to age. There was a tendency for the prognostic significance to increase with age irrespective of ejection fraction. Conclusion The prognostic significance and cut-off value of the VE/VCO2 slope may increase with advancing age.

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