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July 1, 1999Medicine & Science in Sports & Exercise

Ventilatory responses to exercise in patients with asymptomatic left ventricular dysfunction

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Why the study?

Does 6 months of exercise training improve ventilatory responses to effort in patients with coronary artery disease and varying degrees of left ventricular dysfunction?

Population

102 patients with coronary artery disease and various degrees of left ventricular impairment. Excluded: lung…

Comparison

6 months of exercise training in a… vs Pre-training baseline and comparison across…

Design

Cohort

Follow-up

6 months

Authors

ADAndrés DigenioTNTimothy D. NoakesHJHelen Joughin

Discussion

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Overview

Exercise training may not improve ventilatory efficiency in severe LV dysfunction; hypothesis-generating for targeted interventions in low-EF CAD.

Key Points

  • To assess ventilatory responses during exercise in patients with coronary artery disease and varying degrees of left ventricular impairment before and after a six-month cardiac rehabilitation program.
  • Enrolled 102 patients with coronary artery disease referred to a community-based cardiac rehabilitation program, stratified by ejection fraction (EF): Group 1 (EF ≥ 50%, n=63), Group 2 (EF 35–49%, n=21), and Group 3 (EF < 35%, n=18).
  • Excluded 15 patients with pulmonary disease and 54 due to poor exercise adherence.
  • Assessed peak oxygen uptake, minute ventilation (V̇E), minute carbon dioxide production (V̇CO2), and the V̇E/V̇CO2 slope during treadmill tests before and after 6 months of exercise training.
  • All groups significantly increased peak oxygen uptake and treadmill time following exercise training (G1: P=0.0001 for both; G2: P=0.0001 and P=0.001; G3: P=0.01 and P=0.01).
  • Group 3 exhibited a significantly higher V̇E/V̇CO2 ratio than Group 2 and Group 1 at 9 minutes and peak exercise both before training (9 min: P=0.046 and P=0.025; peak: P=0.024 and P=0.002) and after training (9 min: P=0.011 and P=0.005; peak: P=0.001 and P=0.0001).
  • The V̇E to V̇CO2 slope was significantly higher in Group 3 compared with Groups 2 and 1 (P=0.0001 for each comparison) and remained unchanged by exercise training across all groups.

Structured PICO

Does 6 months of exercise training improve ventilatory responses to effort in patients with coronary artery disease and varying degrees of left ventricular dysfunction?

P
Population
102 patients with coronary artery disease and various degrees of left ventricular impairment (Group 1: n=63, EF ≥ 50%; Group 2: n=21, EF 35-49%; Group 3: n=18, EF < 35%). Excluded: lung disease and poor adherence.
I
Intervention
6 months of exercise training in a community-based cardiac rehabilitation program
C
Comparator
Pre-training baseline (within-group comparison) and comparison across ejection fraction groups
O
Outcome
Peak oxygen uptake, minute ventilation (V̇E), and minute carbon dioxide production (V̇CO2) before and after trainingsurrogate

While exercise training improves effort tolerance in patients with coronary artery disease regardless of LV function, it does not normalize the exaggerated ventilatory response to exercise seen in severe LV dysfunction.

Cite This Study

Digenio et al. (1999) studied this question.

synapsesocial.com/papers/6a1cd9186552df3dce1daf9fhttps://doi.org/10.1097/00005768-199907000-00005
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiopulmonary Exercise Response in Patients with Left Ventricular Dysfunction or Heart Failure: A Noninvasive Study by Gas Exchange and Impedance Cardiography Monitoring2008 · 7 citations
  2. 2Influence of high-intensity exercise training on the ventilatory response to exercise in patients with reduced ventricular function1999 · 54 citations
  3. 3The role of right and left ventricular function in the ventilatory response to exercise in chronic heart failure.1994 · 78 citations
  4. 4Improvement of left ventricular contractile function by exercise training in patients with coronary artery disease.1986 · 154 citations
  5. 5The increased ventilatory response to exercise in chronic heart failure: relation to pulmonary pathology.1997 · 77 citations