We have located links that may give you full text access.
Journal Article
Research Support, Non-U.S. Gov't
Gas Exchange and Ventilatory Efficiency During Exercise in Pulmonary Vascular Diseases.
Archivos de bronconeumología. 2020 September
BACKGROUND AND OBJECTIVE: Ventilatory inefficiency (high V'E /V'CO2 ) and resting hypocapnia are common in pulmonary vascular disease and are associated with poor prognosis. Low resting PaCO2 suggests increased chemosensitivity or an altered PaCO2 set-point. We aimed to determine the relationships between exercise gas exchange variables reflecting the PaCO2 set-point, exercise capacity, hemodynamics and V'E /V'CO2 .
METHODS: Pulmonary arterial hypertension (n=34), chronic thromboembolic pulmonary hypertension (CTEPH, n=19) and pulmonary veno-occlusive disease (PVOD, n=6) patients underwent rest and peak exercise arterial blood gas measurements during cardiopulmonary exercise testing. Patients were grouped according to resting PaCO2 : hypocapnic (PaCO2 ≤34mmHg) or normocapnic (PaCO2 35-45mmHg). The PaCO2 set-point was estimated by the maximal value of end-tidal PCO2 (maximal PET CO2 ) between the anaerobic threshold and respiratory compensation point.
RESULTS: The hypocapnic group (n=39) had lower resting cardiac index (3.1±0.8 vs. 3.7±0.7L/min/m2 , p<0.01), lower peak V'O2 (15.8±3.5 vs. 20.7±4.3mL/kg/min, p<0.01), and higher V'E /V'CO2 slope (60.6±17.6 vs. 38.2±8.0, p<0.01). At peak exercise, hypocapic patients had lower PaO2 , higher VD /VT and higher P(a-ET) CO2 . Maximal PET CO2 (r=0.59) and VD /VT (r=-0.59) were more related to cardiac index than PaO2 or PaCO2 at rest or peak exercise. Maximal PET CO2 was the strongest correlate of V'E /V'CO2 slope (r=-0.86), peak V'O2 (r=0.64) and peak work rate (r=0.49).
CONCLUSIONS: Resting hypocapnia is associated with worse cardiac function, more ventilatory inefficiency and reduced exercise capacity. This could be explained by elevated chemosensitivity and lower PaCO2 set-point. Maximal PET CO2 may be a useful non-invasive marker of PaCO2 setpoint and disease severity even with submaximal effort.
METHODS: Pulmonary arterial hypertension (n=34), chronic thromboembolic pulmonary hypertension (CTEPH, n=19) and pulmonary veno-occlusive disease (PVOD, n=6) patients underwent rest and peak exercise arterial blood gas measurements during cardiopulmonary exercise testing. Patients were grouped according to resting PaCO2 : hypocapnic (PaCO2 ≤34mmHg) or normocapnic (PaCO2 35-45mmHg). The PaCO2 set-point was estimated by the maximal value of end-tidal PCO2 (maximal PET CO2 ) between the anaerobic threshold and respiratory compensation point.
RESULTS: The hypocapnic group (n=39) had lower resting cardiac index (3.1±0.8 vs. 3.7±0.7L/min/m2 , p<0.01), lower peak V'O2 (15.8±3.5 vs. 20.7±4.3mL/kg/min, p<0.01), and higher V'E /V'CO2 slope (60.6±17.6 vs. 38.2±8.0, p<0.01). At peak exercise, hypocapic patients had lower PaO2 , higher VD /VT and higher P(a-ET) CO2 . Maximal PET CO2 (r=0.59) and VD /VT (r=-0.59) were more related to cardiac index than PaO2 or PaCO2 at rest or peak exercise. Maximal PET CO2 was the strongest correlate of V'E /V'CO2 slope (r=-0.86), peak V'O2 (r=0.64) and peak work rate (r=0.49).
CONCLUSIONS: Resting hypocapnia is associated with worse cardiac function, more ventilatory inefficiency and reduced exercise capacity. This could be explained by elevated chemosensitivity and lower PaCO2 set-point. Maximal PET CO2 may be a useful non-invasive marker of PaCO2 setpoint and disease severity even with submaximal effort.
Full text links
Related Resources
Trending Papers
Review article: Recent advances in ascites and acute kidney injury management in cirrhosis.Alimentary Pharmacology & Therapeutics 2024 March 26
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app