Effect of increased inspired oxygen on exercise performance in patients with heart failure and normal ejection fraction

Shah, Parin; Pellicori, Pierpaolo; Rimmer, Stella; Rigby, Alan S.; Clark, Andrew L.

Abstract

Introduction: We investigated whether increased concentrations of inspired oxygen (FiO2) affects exercise tolerance in patients with heart failure and normal ejection fraction (HeFNEF). Methods: 46 patients (mean age 75 years (63% male) and median NTproBNP 1432 (interquartile range: 543–2378 ng/l)) with HeFNEF (defined as signs or symptoms of heart failure requiring treatment with diuretics, with a left ventricular ejection fraction of >45% by echocardiography and amino terminal pro brain natriuretic peptide (NTproBNP) >220 ng/l) completed three maximal incremental exercise tests with different FiO2 (21%, 28% and 40%) in random order. FiO2 was controlled by investigator but blinded to patients. The primary outcome was exercise time (ET). Results: Increasing FiO2 significantly increased exercise time (522 ± 180 seconds for 21% to 543 ± 176 seconds, and 542 ± 177 seconds, for 28% and 40%, respectively, P = 0.04) with no difference in peak workload (57 ± 25 W, 58 ± 25 W and 57 ± 25 W, for 21%, 28% and 40%, respectively, P = 0.50). There was an increase in oxygen saturation but no change in peak heart rate with increasing FiO2. Compared to patients with LVEF ≥50%, patients with LVEF between 45 and 49% had a significantly greater exercise time and peak workload. There was a correlation between the difference in exercise time between FiO2 21% and 40% and age; but not with BMI, haemoglobin, creatinine or NTproBNP. Conclusion: Increasing FiO2 during exertion leads to a small increase in exercise time in patients with HeFNEF.

Citation

Shah, P., Pellicori, P., Rimmer, S., Rigby, A. S., & Clark, A. L. (2018). Effect of increased inspired oxygen on exercise performance in patients with heart failure and normal ejection fraction. International journal of cardiology, 268, 166-169. https://doi.org/10.1016/j.ijcard.2018.05.029

• Journal Article Type: Article
• Acceptance Date: May 9, 2018
• Online Publication Date: May 24, 2018
• Publication Date: Oct 1, 2018
• Deposit Date: Jun 3, 2018
• Publicly Available Date: May 25, 2019
• Print ISSN: 0167-5273
• Electronic ISSN: 1874-1754
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 268
• Pages: 166-169
• DOI: https://doi.org/10.1016/j.ijcard.2018.05.029
• Keywords: Heart failure with normal ejection fraction; Exercise; Oxygen
• Public URL: https://hull-repository.worktribe.com/output/861442
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S016752731737345X