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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.

Authors

Parin Shah

Pierpaolo Pellicori

Stella Rimmer

Alan S. Rigby

Andrew L. Clark



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
Copyright Statement © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

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