- 著者
- Toshiyuki Nagai Takayuki Inomata Takashi Kohno Takuma Sato Atsushi Tada Toru Kubo Kazufumi Nakamura Noriko Oyama-Manabe Yoshihiko Ikeda Takeo Fujino Yasuhide Asaumi Takahiro Okumura Toshiyuki Yano Kazuko Tajiri Hiroyuki Matsuura Yuichi Baba Haruki Sunami Shingo Tsujinaga Yasutoshi Ota Keiko Ohta-Ogo Yusuke Ishikawa Hideo Matama Nobutaka Nagano Kimi Sato Kazushi Yasuda Yasushi Sakata Koichiro Kuwahara Tohru Minamino Minoru Ono Toshihisa Anzai on behalf of the Japanese Circulation Society Joint Working Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-22-0696, (Released:2023-03-10)
- 被引用文献数
- 17
- 著者
- Shingo Tsujinaga Hiroyuki Iwano Yasuyuki Chiba Suguru Ishizaka Miwa Sarashina Michito Murayama Masahiro Nakabachi Hisao Nishino Shinobu Yokoyama Kazunori Okada Sanae Kaga Toshihisa Anzai
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.2, no.5, pp.271-279, 2020-05-08 (Released:2020-05-08)
- 参考文献数
- 27
- 被引用文献数
- 3
Background:Ventilatory inefficiency during exercise assessed using the lowest minute ventilation/carbon dioxide production (V̇E/V̇CO2) ratio was recently proven to be a strong prognostic marker of heart failure (HF) regardless of left ventricular ejection fraction (LVEF). Its physiological background, however, has not been elucidated.Methods and Results:Fifty-seven HF patients underwent cardiopulmonary exercise testing and exercise-stress echocardiography. The lowest V̇E/V̇CO2ratio was assessed on respiratory gas analysis. Echocardiography was obtained at rest and at peak exercise. LVEF was measured using the method of disks. Cardiac output (CO) and the ratio of transmitral early filling velocity (E) to early diastolic tissue velocity (e’) were calculated using the Doppler method. HF patients were divided into preserved EF (HFpEF) and reduced EF (HFrEF) using the LVEF cut-off 40% at rest. Twenty-four patients were classified as HFpEF and 33 as HFrEF. In HFpEF, age (r=0.58), CO (r=−0.44), e’ (r=−0.48) and E/e’ (r=0.45) during exercise correlated with the lowest V̇E/V̇CO2ratio (P<0.05 for all). In contrast, in HFrEF, age (r=0.47) and CO (r=−0.54) during exercise, but not e’ and E/e’, correlated with the lowest V̇E/V̇CO2ratio.Conclusions:Loss of CO augmentation was associated with ventilatory inefficiency in HF regardless of LVEF, although lung congestion determined ventilatory efficiency only in HFpEF.