Source: Annual Congress 2012 - Exercise capacity: from elite athletes to severe impairment
Disease area: Airway diseases, Pulmonary vascular diseases

Abstract

We have demonstrated in healthy subjects that the rate of increase in minute ventilation over heart rate (ΔV‘_E/ΔHR), during incremental exercise, is described by a bilinear response, with a slope‘s change at the ventilatory compensation point (VCP)(Onorati P., Eur J Appl Physiol, 2008;104:87–94;Med Sci Sports Exerc 2012 in press). We aimed at analyzing the exercise ΔV‘_E/ΔHR response in patients with chronic cardiopulmonary diseases. Methods. Patients with chronic obstructive pulmonary disease (COPD) (n=10) and cardiovascular diseases (CVD)(Pulmonary Arterial Hypertension, PAH, n=9; and Chronic Heart Failure, CHF, n=10) underwent one-minute incremental cycling exercise. Gas exchange, V‘_E, HR were measured breath-by-breath. ΔV‘_E/ΔHR response, before (S₁) and after the VCP (S₂) were computed by linear regression analysis. Results. In all patients we observed a linear response of the ΔV‘_E/ΔHR relationship; in COPD patients S₁ was steeper vs PAH and CHF and approached maximal voluntary ventilation (MVV). S₂ slope was observed manly in CVD patients and approached maximal predicted HR.

A good agreement (Bland-Altman test) for VCP detection was observed between ΔV‘_E/ΔHR vs the ventilatory equivalent for CO₂ (V‘_E/V‘CO₂) methods. Conclusions. In patients with COPD and CVD, the ΔV‘_E/ΔHR response during cycling incremental exercise can be utilized to discriminate between ventilatory and circulatory limitation.

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Citations should be made in the following way:
P. Onorati, P. Marinelli, P. Paoletti, A.M. Ferrazza, G. Valli, M. Internullo, D. Martolini, P. Palange (Rome, Italy). Minute ventilation (V‘_E) and heart rate (HR) relationship during exercise in chronic cardiac and pulmonary diseases. Eur Respir J 2012; 40: Suppl. 56, 856

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