Metabolic responses to exercise in patients with heart failure

S I Rajfer; J W Nemanich; A J Shurman; J D Rossen

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Metabolic responses to exercise in patients with heart failure

Journal article

Peer reviewed

Metabolic responses to exercise in patients with heart failure

S I Rajfer, J W Nemanich, A J Shurman and J D Rossen

Circulation (New York, N.Y.), Vol.76(6 Pt 2), pp.VI46-I-53

12/1987

PMID: 3677364

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Abstract

Metabolic and hemodynamic responses to exercise were evaluated in 10 patients with chronic congestive heart failure. We utilized an exercise protocol in which the work rate was increased continuously and oxygen uptake (VO2) kinetics were characterized by linear, first-order dynamics. VO2 at peak exercise (VO2max) was depressed at 12.8 +/- 2.3 ml/min/kg and the anaerobic threshold occurred at 63 +/- 10% of the VO2max. A significant correlation was observed between the VO2 at the anaerobic threshold and the resting cardiac index (r = .74, p less than .05). Ventilation-perfusion relationships improved during exercise, despite the presence of a widened alveolar-arterial gradient in oxygen tension and elevation of the physiologic dead space/tidal volume ratio. At peak exercise, a large breathing reserve (maximal voluntary ventilation-minute ventilation), a decline in arterial carbon dioxide tension, and a slight increase in arterial oxygen tension were observed. Plasma epinephrine levels at peak exercise correlated directly with VO2max (r = .74, p less than .05). Thus, although disturbances in ventilation-perfusion relationships occur in association with heart failure, exercise is not limited by an impairment in pulmonary function. The glycogenolytic action of epinephrine may play an important role in determining peak exercise capacity since glycogen stores are increasingly utilized at work rates above the anaerobic threshold.

Anaerobiosis

Lactates - blood

Humans

Middle Aged

Heart Failure - physiopathology

Oxygen Consumption

Male

Heart Failure - metabolism

Exercise Test

Norepinephrine - blood

Epinephrine - blood

Female

Pulmonary Gas Exchange

Aged

Hemodynamics

Respiration

Details

Title: Subtitle: Metabolic responses to exercise in patients with heart failure
Creators: S I Rajfer - Department of Medicine, University of Chicago, IL 60637
J W Nemanich
A J Shurman
J D Rossen
Resource Type: Journal article
Publication Details: Circulation (New York, N.Y.), Vol.76(6 Pt 2), pp.VI46-I-53
PMID: 3677364
NLM abbreviation: Circulation
ISSN: 0009-7322
eISSN: 1524-4539
Publisher: Lippincott Williams & Wilkins; United States
Grant note: HL-00872 / NHLBI NIH HHS GM-22220 / NIGMS NIH HHS GM-07019 / NIGMS NIH HHS
Language: English
Date published: 12/1987
Academic Unit: Neurology; Cardiovascular Medicine; Neurosurgery; Internal Medicine
Record Identifier: 9984020891102771

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