Diaphragmatic function after intense exercise in congestive heart failure patients

被引:20
作者
Kufel, TJ [1 ]
Pineda, LA [1 ]
Junega, RG [1 ]
Hathwar, R [1 ]
Mador, MJ [1 ]
机构
[1] SUNY Buffalo, Div Pulm & Crit Care Med 111S, Buffalo Sch Med & Biomed Sci, VA Western New York Healthcare Syst,Dept Med, Buffalo, NY 14215 USA
关键词
congestive heart failure; diaphragm; exercise; fatigue;
D O I
10.1183/09031936.02.00016702
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Respiratory muscle strength and endurance is reduced in patients with congestive heart failure, making these patients susceptible to diaphragmatic fatigue during exercise. In order to determine whether or not contractile fatigue of the diaphragm occurs in patients with congestive heart failure following intense exercise, twitch transdiaphragmatic pressures (twitch Ptdi) were measured during unpotentiated and potentiated cervical magnetic stimulation (CMS) of the phrenic nerves before and at intervals after cycle endurance exercise. Ten patients aged 65.7 +/- 6.0 yrs (mean +/- SD) with an ejection fraction of 31.2 +/- 9.8%) performed a constant-load symptom-limited exercise test at 60% of their peak work capacity. Twitch Ptdi at baseline were 15.9 +/- 6.3 cmH(2)O (unpotentiated CMS) and 28.8 +/- 10.7 cmH(2)O (potentiated CMS) and at 10 min postexercise were 16.4 +/- 4.7 cmH(2)O (unpotentiated CMS) and 27.6 +/- 10.1 cmH(2)O (potentiated CMS). One patient demonstrated a sustained fall in twitch Ptdi of greater than or equal to15%, considered potentially indicative of diaphragmatic fatigue. Contractile diaphragmatic fatigue is uncommon in untrained patients with congestive heart failure following high-intensity constant-workload cycle exercise. Therefore, diaphragmatic fatigue is an unlikely cause of exercise-limitation during activities of daily living in heart failure patients.
引用
收藏
页码:1399 / 1405
页数:7
相关论文
共 31 条
[2]   CONTRIBUTION OF DIAPHRAGMATIC POWER OUTPUT TO EXERCISE-INDUCED DIAPHRAGM FATIGUE [J].
BABCOCK, MA ;
PEGELOW, DF ;
MCCLARAN, SR ;
SUMAN, OE ;
DEMPSEY, JA .
JOURNAL OF APPLIED PHYSIOLOGY, 1995, 78 (05) :1710-1719
[3]   Randomized, controlled trial of long-term moderate exercise training in chronic heart failure - Effects on functional capacity, quality of life, and clinical outcome [J].
Belardinelli, R ;
Georgiou, D ;
Cianci, G ;
Purcaro, A .
CIRCULATION, 1999, 99 (09) :1173-1182
[4]  
CRAPO RO, 1982, B EUR PHYSIOPATH RES, V18, P419
[5]  
CRAPO RO, 1981, AM REV RESPIR DIS, V123, P185
[6]  
CRAPO RO, 1981, AM REV RESPIR DIS, V123, P659
[7]   Symptom intensity and subjective limitation to exercise in patients with cardiorespiratory disorders [J].
Hamilton, AL ;
Killian, KJ ;
Summers, E ;
Jones, NL .
CHEST, 1996, 110 (05) :1255-1263
[8]   RESPIRATORY MUSCLE STRENGTH IN CONGESTIVE-HEART-FAILURE [J].
HAMMOND, MD ;
BAUER, KA ;
SHARP, JT ;
ROCHA, RD .
CHEST, 1990, 98 (05) :1091-1094
[9]   Inspiratory muscle relaxation rate slows during exhaustive treadmill walking in patients with chronic heart failure [J].
Hughes, PD ;
Hart, N ;
Hamnegård, CH ;
Green, M ;
Coats, AJS ;
Moxham, J ;
Polkey, MI .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 163 (06) :1400-1403
[10]   EXERCISE-INDUCED DIAPHRAGMATIC FATIGUE IN HEALTHY HUMANS [J].
JOHNSON, BD ;
BABCOCK, MA ;
SUMAN, OE ;
DEMPSEY, JA .
JOURNAL OF PHYSIOLOGY-LONDON, 1993, 460 :385-405