Airway resistance in chronic heart failure measured by impulse oscillometry

J Card Fail. 2002 Aug;8(4):225-31. doi: 10.1054/jcaf.2002.126916.

Abstract

Background: Patients with chronic heart failure (CHF) complain of breathlessness and fatigue on exertion, have reduced peak oxygen consumption (pV(O(2))), and an increased ventilatory response to exercise (V(E)/V(CO(2)) slope). These limitations correlate with abnormalities of spirometry (forced expiratory volume in 1 second [FEV(1)] and forced ventilatory capacity [FVC]). Increased airway resistance by increasing the work of breathing might contribute to exercise intolerance in CHF.

Methods: Impulse oscillometry (IOS) measures airway resistance and lung compliance independently of respiratory muscle strength and patient compliance. Sound waves of varying frequencies are sent into the lungs and the amplitude and phase shift of the reflected waves give a measure of airway resistance (R) and reactance (X). Twenty-three CHF patients and 18 controls underwent peak exercise testing with metabolic gas analysis and had airway resistance assessment using the Jaeger (W├╝rtzberg, Germany) IOS system.

Results: Patients had a lower pV(O(2)) (18.7 (4.0) v 39.2 (8.3) mL x kg x min; P < .0001), elevated V(E)/V(CO(2)) slope (41.6 (8.1) v 27.4 (2.9)), and lower FEV(1) (2.4 (0.4) v 3.2 (0.7) L/min; P = .0001) and FVC (3.3 (0.7) v 4.1 (1.1) L; P < .005) than controls. R and X correlated with spirometric abnormalities and were different between patients and controls (R at 5 Hz 0.44 (0.16) v 0.30 (0.15) kPa (L/s); P < .005 and X at 5 Hz -0.16 (0.08) v -0.09 (0.08) kPa (L/s); P < .05). R at 5 Hz correlated with pV(O(2)) (0.46; P = .0025) and V(E)/V(CO(2)) slope (0.43; P < .05).

Conclusion: CHF patients have elevated airway resistance and reduced reactance measured with IOS compared with control subjects.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Airway Resistance / drug effects
  • Airway Resistance / physiology*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Chronic Disease
  • Exercise Test
  • Female
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology
  • Heart Failure / drug therapy
  • Heart Failure / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Oscillometry / methods*
  • Predictive Value of Tests
  • Pulmonary Gas Exchange / drug effects
  • Pulmonary Gas Exchange / physiology
  • Receptors, Angiotensin / therapeutic use
  • Smoking / adverse effects
  • Statistics as Topic
  • Vital Capacity / drug effects
  • Vital Capacity / physiology

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Receptors, Angiotensin