Inspiratory Capacity and Dynamic Hyperinflation During Exercise in Patients With Cardiovascular Disease: A SYSTEMATIC...

Area of Science:

• Cardiopulmonary Exercise Physiology
• Cardiovascular Disease Research
• Pulmonary Function Testing

Background:

• Expiratory flow limitation (EFL) and dynamic hyperinflation (DH) are recognized contributors to exercise intolerance.
• While primarily associated with lung diseases, their role in cardiovascular disease (CVD) is gaining attention.
• Understanding pulmonary function during exercise in CVD patients is crucial for improving management.

Purpose of the Study:

• To systematically review the literature on pulmonary function during exercise in patients with CVD over the past decade.
• To determine the prevalence and clinical significance of EFL and DH in CVD.
• To examine the utility of inspiratory capacity (IC) maneuvers in assessing these conditions.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Cochrane databases (January 2014-February 2024).
• Inclusion of studies measuring pulmonary function during exercise in CVD patients using IC maneuvers.
• Independent review of selected studies using established Quality Assessment Tools.

Main Results:

• Seven studies involving 231 CVD patients were analyzed, with mixed study quality.
• EFL was observed at moderate exercise in myocardial infarction patients and at high intensities in stable coronary artery disease.
• DH prevalence varied: up to 50% in pulmonary arterial hypertension, 25% in heart failure, and absent in post-Fontan patients.
• Methodological inconsistencies limit definitive conclusions on DH prevalence.

Conclusions:

• Reduced IC during exercise, DH, and EFL are present in a significant portion of CVD patients.
• These findings suggest an earlier onset of ventilatory constraints in CVD patients.
• Further research on heart-lung interactions during exercise is essential for personalized CVD treatment and management.