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Dynamic Hyperinflation Impairs Cardiac Performance During Exercise in COPD

Frazão, Murillo, MSc, PT; Silva, Paulo Eugênio, MSc, PT; Frazão, Wanessa, PT; da Silva, Vinícius Zacarias Maldaner, PhD, PT; Correia, Marco Aurélio de Valois Jr, MSc, PT; Neto, Mansueto Gomes, PhD, PT

Journal of Cardiopulmonary Rehabilitation and Prevention: May 2019 - Volume 39 - Issue 3 - p 187–192
doi: 10.1097/HCR.0000000000000325
Pulmonary Rehabilitation
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Purpose: To investigate the correlation between a plateau in minute ventilation

E during cardiopulmonary exercise tests (CPETs) and its impact on cardiac performance.

Methods: This retrospective study analyzed 2575 CPETs of patients with chronic obstructive pulmonary disease. The study randomly selected 10 patients with a plateau in the

E curve, suggesting dynamic hyperinflation, 10 patients with normal pattern for the

E curve, and 10 healthy persons. Classic CPET variables, the new ventilation hyperinflation index, and the dynamic cardiac constraint index were analyzed.

Results: The patients with dynamic hyperinflation presented with lower ventilation at 100% work rate (P < .0001), without significant differences in

E at 50% and 100% work rate. Patients with dynamic hyperinflation also presented with a lower oxygen pulse (O2 pulse) at 100% (P < .0001), without significant difference in O2 pulse at 50% and 100% work rate. The subjects with dynamic hyperinflation had a higher ventilation hyperinflation index (P < .0001) and dynamic cardiac constraints index (P < .0001). The ventilation hyperinflation index correlated with the dynamic cardiac constraints index (r = 0.81, P < .0001); oxygen pulse variation (r =−0.63, P < .001);

E/

CO2 slope (r =−0.57, P < .01); work rate (r =−0.86, P < .0001);

O2 (r =−0.80, P < .0001), and

E (r =−0.83, P < .0001).

Conclusion: There is a correlation between a plateau in the

E during CPET, suggesting hyperinflation, and it has an impact on cardiac performance.

We performed a cross-sectional study to investigate the correlation between a plateau in the minute ventilation during cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and its impact on cardiac performance. There is a correlation between a plateau in the minute ventilation exercise testing graph, and it impacts cardiac performance.

Exercise Physiology and Pulmonary Rehabilitation Division, CLINAR Health Care Center, João Pessoa, Brazil (Mr M. Frazão and Ms W. Frazão); Physical Therapy Division, University Hospital de Brasília, Brasilia, Brazil (Mr Silva); Superior Health Science School, Brasilia, Brazil (Dr da Silva); Physical Therapy Department, Universidade de Pernambuco, Recife, Brasil (Mr Correia); and Physical Therapy Department, Federal University of Bahia, Salvador, Brazil (Dr Neto).

Correspondence: Murillo Frazão, MSc, PT, Maria Caetano Fernandes de Lima, St 225, Tambauzinho, João Pessoa, PB58042-050, Brazil (murillo.frazao@gmail.com).

All authors have read and approved of the article.

The authors declare no conflicts of interest.

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