Eccentric Left Ventricular Hypertrophy and Left and Right Cardiac Function in Chronic Heart Failure with or without Coexisting COPD: Impact on Exercise Performance
Received 11 October 2020
Accepted for publication 21 December 2020
Published 3 February 2021 Volume 2021:16 Pages 203—214
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Richard Russell
Polliana B Dos Santos,1 Rodrigo P Simões,1,2 Cássia da L Goulart,1 Meliza G Roscani,3 Renan S Marinho,1 Patrícia Faria Camargo,1 Renata F Arbex,1 Guilherme Casale,3 Cláudio R Oliveira,3 Renata G Mendes,1 Ross Arena,4 Audrey Borghi-Silva1
1Cardiopulmonary Physical Therapy Laboratory, Federal University of Sao Carlos, Sao Carlos, Brazil; 2Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, Minas Gerais, Brazil; 3Department of Medicine, Federal University of Sao Carlos, Sao Carlos, Brazil; 4Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
Correspondence: Audrey Borghi-Silva
Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, UFSCar, São Carlos, São Paulo, Brazil
Aim: Our aim was to assess: 1) the impact of the eccentric left ventricular hypertrophy (ELVH) on exercise performance in patients diagnosed with chronic heart failure (CHF) alone and in patients with co-existing CHF and chronic obstructive pulmonary disease (COPD) and 2) the relationship between left and right cardiac function measurements obtained by doppler echocardiography, clinical characteristics and primary measures of cardiorespiratory fitness.
Methods: The current study included 46 patients (CHF:23 and CHF+COPD:23) that performed advanced pulmonary function tests, echocardiography and symptom-limited, incremental cardiopulmonary exercise testing (CPET) on a cycle ergometer.
Results: Patients with CHF+COPD demonstrated a lower work rate, peak oxygen uptake (VO2), oxygen pulse, rate pressure product (RPP), circulatory power (CP) and ventilatory power (VP) compared to those only diagnosed with CHF. In addition, significant correlations were observed between VP and relative wall thickness (r: 0.45 p: 0.03),VE/VCO2 intercept and Mitral E/e’ ratio (r: 0.70 p: 0.003) in the CHF group. Significant correlations were found between indexed left ventricle mass and RPP (r: − 0.47; p: 0.02) and relative VO2 and right ventricle diameter (r: − 0.62; p: 0.001) in the CHF+COPD group.
Conclusion: Compared to a diagnosis of CHF alone, a combined diagnosis of CHF+COPD induced further impairments in cardiorespiratory fitness. Moreover, echocardiographic measures of cardiac function are related to cardiopulmonary exercise performance and therefore appear to be an important therapeutic target when attempting to improve exercise performance and functional capacity.
Keywords: heart failure, chronic obstructive pulmonary disease, eccentric hypertrophy, ventricular dysfunction, cardiopulmonary exercise testing, echocardiography
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]