Dynamic Hyperinflation Impairs Cardiac Performance During Exercise in COPD
Murillo Frazão1, Paulo Eugênio Silva, Wanessa Frazão
1Exercise 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).
Purpose:
To investigate the correlation between a plateau in minute ventilation (Equation is included in full-text article.)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 (Equation is included in full-text article.)E curve, suggesting dynamic hyperinflation, 10 patients with normal pattern for the (Equation is included in full-text article.)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 (Equation is included in full-text article.)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); (Equation is included in full-text article.)E/(Equation is included in full-text article.)CO2 slope (r =-0.57, P < .01); work rate (r =-0.86, P < .0001); (Equation is included in full-text article.)O2 (r =-0.80, P < .0001), and (Equation is included in full-text article.)E (r =-0.83, P < .0001).
Conclusion:
There is a correlation between a plateau in the (Equation is included in full-text article.)E during CPET, suggesting hyperinflation, and it has an impact on cardiac performance.
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