[Ventilation abnormalities in systolic and diastolic left ventricular dysfunction]

Respiratory disturbances are important element of congestive heart failure. In systolic left ventricle (LV) dysfunction some of ventilation parameters are impaired at early stage of the disease. The knowledge on ventilation disturbances in diastolic LV dysfunction is, however, poor. The aim of the study was to assess ventilation disturbances (using spirometry) in systolic and diastolic LV failure, and to evaluate correlation between spirometric parameters and echocardiographic as well as clinical data in studied groups.

The study was carried out in 56 patients with stable angina, including 17 with no LV dysfunction (I), 18 with diastolic LV dysfunction (II) and 21 systolic and diastolic dysfunction (III). In each patients NYHA class, echocardiographic parameters of systolic and diastolic LV function and spirometry parameters were assessed. Results were expresses as mean +/- standard deviation.

In patients with diastolic dysfunction spirometric indices of obstruction were decreased compared to group I (FEV1% 91.97 +/- 13.54 vs 96.2 +/- 10.43 p < 0.05; FEV1/ FVC 0.72 +/- 0.06 vs 0.78 +/- 0.04, p < 0.05), but higher than in group III (FEV1% 91.97 +/- 13.54 vs 85.78 + 16.41 p < 0.05). Vital capacity was not impaired in either subgroup. MEF75--a spirometric parameter that depends on effort--was impaired in group III compared to I (67.72 +/- 19.7 vs 83.7 +/- 22.73, p < 0.05), while in group II it was similar to group I. No correlation was found between ventilation parameters and NYHA class or echocardiographic indices of LV dysfunction.

Ventilation disturbances in patients with diastolic LV dysfunction are less advanced than in patients with systolic heart failure, but more pronounced than in patients with no LV function impairment. In both systolic and diastolic dysfunction groups patients presented with obstructive pattern in spirometry. In systolic dysfunction obstructon was more pronounced, with significantly impaired effort-dependent phase of ventilation. No correlation was found between ventilation parameters and NYHA class or echocardiographic indices of LV dysfunction