Noninvasive Ventilation Accelerates Oxygen Uptake Recovery Kinetics in Patients With Combined Heart Failure and
Adriana Mazzuco1, Aline Soares Souza, Cássia da Luz Goulart
1Cardiopulmonary Physical Therapy Laboratory (LACAP), Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil (Drs Mazzuco and Borghi-Silva and Ms Goulart); Pulmonary Function and Clinical Exercise Physiology Unit (SEFICE), Respiratory Division, Federal University of São Paulo (UNIFESP), Brazil (Drs Souza, Medeiros, Sperandio, Alencar, Arbex, and Neder); Laboratory of Clinical Exercise Physiology (LACEP), Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen's University, Kingston, Canada (Dr Neder); and Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago (Dr Arena).
Purpose:
Oxygen uptake (V˙o2) recovery kinetics appears to have considerable value in the assessment of functional capacity in both heart failure (HF) and chronic obstructive pulmonary disease (COPD). Noninvasive positive pressure ventilation (NIPPV) may benefit cardiopulmonary interactions during exercise. However, assessment during the exercise recovery phase is unclear. The purpose of this investigation was to explore the effects of NIPPV on V˙o2, heart rate, and cardiac output recovery kinetics from high-intensity constant-load exercise (CLE) in patients with coexisting HF and COPD.
Methods:
Nineteen males (10 HF/9 age- and left ventricular ejection fraction-matched HF-COPD) underwent 2 high-intensity CLE tests at 80% of peak work rate to the limit of tolerance (Tlim), receiving either sham ventilation or NIPPV.
Results:
Despite greater V˙o2 recovery kinetics on sham, HF-COPD patients presented with a faster exponential time constant τ (76.4 ± 14.0 sec vs 62.8 ± 15.2 sec, P < .05) and mean response time (MRT) (86.1 ± 19.1 sec vs 68.8 ± 12.0 sec, P < .05) with NIPPV and greater ΔNIPPV-sham (τ: 5.6 ± 19.5 vs -25.2 ± 22.4, P < .05; MRT: 4.1 ± 32.2 vs -26.0 ± 19.2, P < .05) compared with HF. There was no difference regarding Tlim between sham and NIPPV in both groups (P < .05).
Conclusion:
Our results suggest that NIPPV accelerated the V˙o2 recovery kinetics following high-intensity CLE to a greater extent in patients with coexisting HF and COPD compared with HF alone. NIPPV should be considered when the objective is to apply high-intensity interval exercise training as an adjunct intervention during a cardiopulmonary rehabilitation program.
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