Abnormalities of the ventilatory equivalent for carbon dioxide in patients with chronic heart failure
Author(s)
Type
Journal Article
Abstract
Introduction. The relation between minute ventilation (VE) and carbon dioxide production (VCO(2)) can be characterised by the instantaneous ratio of ventilation to carbon dioxide production, the ventilatory equivalent for CO(2) (VEqCO(2)). We hypothesised that the time taken to achieve the lowest VEqCO(2) (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 63 ± 12 years; 80% males) and 78 healthy controls (62% males; age 61 ± 11 years) were recruited. Time to VEqCO2 nadir was shorter in patients than controls (327 ± 204 s versus 514 ± 187 s; P = 0.0001). Univariable predictors of all-cause mortality included peak oxygen uptake (X(2) = 53.0), VEqCO(2) nadir (X(2) = 47.9), and time to VEqCO(2) nadir (X(2) = 24.0). In an adjusted Cox multivariable proportional hazards model, peak oxygen uptake (X(2) = 16.7) and VEqCO(2) nadir (X(2) = 17.9) were the most significant independent predictors of all-cause mortality. Conclusion. The time to VEqCO(2) nadir was shorter in patients with CHF than in normal subjects and was a predictor of subsequent mortality.
Date Issued
2012-02-09
Date Acceptance
2012-02-09
Citation
Pulmonary Medicine, 2012, 2012
ISSN
2090-1844
Publisher
Hindawi Publishing Corporation
Journal / Book Title
Pulmonary Medicine
Volume
2012
Copyright Statement
© 2012 Lee Ingle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Publication Status
Published
Article Number
589164