Relation Between Oscillatory Breathing and Cardiopulmonary Function During Exercise in Cardiac Patients

• Published in: Circulation Journal 2013, Vol.77(3), pp.661-666
• Main Authors: Kato, Jo, Koike, Akira, Hoshimoto-Iwamoto, Masayo, Nagayama, Osamu, Sakurada, Koji, Sato, Akira, Yamashita, Takeshi, Wasserman, Karlman, Aonuma, Kazutaka
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carbon Dioxide - metabolism; Cardiopulmonary function; Exercise - physiology; Exercise Test; Exercise testing; Female; Heart - physiopathology; Heart Failure - physiopathology; Heart Failure - rehabilitation; Humans; Lung - physiopathology; Male; Middle Aged; Oscillatory ventilation; Oxygen - metabolism; Oxygen Consumption - physiology; Pulmonary Gas Exchange - physiology; Respiration; Retrospective Studies; Time Factors
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-12-0925

Background: Oscillatory breathing, alternating between hyperpnea and hypopnea, has been recognized in cardiac patients, especially in those with heart failure. We evaluated whether the cycle length and amplitude of oscillatory breathing correlate with impaired cardiopulmonary function during exercise. Methods and Results: We analyzed respiratory gas data during cardiopulmonary exercise testing (CPX) in 17 cardiac patients (68±12 years) who showed clear oscillatory ventilation during CPX. The cycle length (time from peak to peak) and the amplitude (difference between peak and nadir) for both oscillating ventilation (VE) and oscillating O2 uptake (VO2) were calculated from several consecutive oscillations noted at rest, and compared with indices of CPX. Oscillating VO2 preceded oscillating VE in 16 of the 17 patients. Peak VO2 (10.3±3.1mlmin–1kg–1) correlated significantly negatively with the cycle length of the VE oscillation (r=–0.60, P=0.010), and of the VO2 oscillation (r=–0.61, P=0.008), and the difference in time between the peak of oscillating VE and the corresponding peak of VO2 (r=–0.58, P=0.012). Similarly, the slope of the increase in VE to the increase in CO2 output (45.6±11.5) correlated significantly positively with the cycle length of the VE and VO2 oscillations (r=0.68, P=0.002; r=0.67, P=0.003, respectively). Conclusions: The cycle length of oscillatory breathing is closely related to impaired cardiac reserve during exercise in cardiac patients.  (Circ J 2013; 77: 661–666)