Key result
Exercise training significantly reversed exercise oscillatory ventilation in nearly 70% of chronic heart failure patients (RR 0.30).
Why the study?
EOV independently predicts death and adverse cardiovascular events in CHF, but evidence regarding exercise training as an EOV treatment is limited and no effective pharmacological therapy exists.
Meta-Analysis (n=98)
Relative Risk: 0.3 (95% CI 0.21–0.43)
p-value: p=<0.001
Supports supervised exercise to target high-risk EOV in chronic HF; extends meta-analytic evidence for its role beyond functional gains.
Exercise oscillatory ventilation (EOV) is a phenomenon characterized by cyclic oscillations in the ventilatory pattern observed during the cardiopulmonary exercise test (EOV characteristics: Supplementary material online, Figure 1S). It is considered an independent predictor for death and adverse cardiovascular events in chronic heart failure (CHF) patients.1 A recent meta-analysis showed that EOV-positive patients exhibited a worse peak oxygen uptake (VO2PEAK) and ventilatory efficiency (VE/VCO2 slope).2 Although the EOV pathophysiology is not fully understood, current evidence suggests that circulatory delay, pulmonary congestion, high chemosensitivity, and exacerbated ergoreflex signalling are the main triggering factors.1,3 Several treatments were investigated to alleviate EOV symptomatology and thereby improve the patient’s prognosis (e.g. adaptive servo-ventilation, phosphodiesterase 5 inhibition, exercise training and levosimendan infusion). Although the evidence regarding exercise training as EOV treatment is limited, there is also no effective pharmacological treatment for EOV. Thus, targeting EOV by...
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Ribeiro et al. (2021) conducted a meta-analysis in Chronic heart failure with exercise oscillatory ventilation (EOV) (n=98). Exercise training vs. Pre-training baseline (single arm) or control group was evaluated on EOV reversal (RR 0.30, 95% CI 0.21-0.43, p=<0.001). Exercise training significantly reversed exercise oscillatory ventilation in nearly 70% of chronic heart failure patients (RR 0.30).
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