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Poor relationship between exercise capacity and spirometric measurements in patients with more symptomatic heart failure

Ingle, Lee; Shelton, Rhidian J.; Cleland, John G.F.; Clark, Andrew L.

Authors

Rhidian J. Shelton

John G.F. Cleland

Andrew L. Clark



Abstract

Background: The origin of exercise limitation in patients with chronic heart failure (CHF) is multifactorial, and the relative contributions of different abnormalities may vary with severity of heart failure symptoms. The aim of the current study was to determine the extent to which spirometric indices predict peak exercise capacity in patients with differing severity of symptoms. Methods and Results: A total of 340 patients with left ventricular systolic dysfunction underwent spirometry, and a ramped, maximal exercise treadmill test with metabolic gas exchange measurements. For comparative purposes, a group of 174 aged-matched controls with no major structural heart disease (MSHD) was also included. In a stepwise linear regression model, forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) were independent predictors of peak oxygen uptake (pV̇O 2 ) in controls (r 2 = 18-25%; P = .001) and New York Heart Association (NYHA) I-II patients (r 2 = 16-18%; P = .001). No association between spirometric indices (FEV 1 /FVC) and pV̇O 2 (r 2 = 1-2%; P > .05) was found in NYHA III-IV patients. Conclusion: In aged-matched controls with no MSHD, spirometric variables (FEV 1 /FVC) explain 18% to 25% of the variance in pV̇O 2 , and 16% to 18% of the variance in patients with NYHA class I-II symptoms. As symptoms worsen, the influence of spirometric variables on peak exercise capacity diminishes, and there is no such relation in the NYHA class III-IV patients. © 2005 Elsevier Inc. All rights reserved.

Journal Article Type Article
Publication Date 2005-10
Journal Journal of Cardiac Failure
Print ISSN 1071-9164
Electronic ISSN 1532-8414
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 11
Issue 8
Pages 619-623
Institution Citation Ingle, L., Shelton, R. J., Cleland, J. G., & Clark, A. L. (2005). Poor relationship between exercise capacity and spirometric measurements in patients with more symptomatic heart failure. Journal of cardiac failure, 11(8), 619-623. https://doi.org/10.1016/j.cardfail.2005.06.430
DOI https://doi.org/10.1016/j.cardfail.2005.06.430
Keywords Chronic heart failure; Symptoms; Exercise capacity; Spirometry
Publisher URL https://www.sciencedirect.com/science/article/pii/S1071916405006779?via%3Dihub