Open AccessClinical Significance of Awake Oscillatory Ventilation in Patients with Heart Failure and Effects of Open‐Heart Surgery
Author(s) -
Ueshima Kenji,
Kobayashi Noboru,
Yamazaki Takuya,
Saitoh Masahiko,
Nakamura Motoyuki,
Nakao Kazuwa
Publication year - 2010
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20572
Subject(s) - medicine , heart failure , ventilation (architecture) , clinical significance , anesthesia , anaerobic exercise , statistical significance , cardiac surgery , hemodynamics , cardiology , surgery , mechanical engineering , physiology , engineering
Background Although sleep apnea has recently become a concern in patients with congestive heart failure (CHF), some patients with CHF exhibit characteristic oscillatory ventilation (OV) even when they are awake. We investigated the clinical significance of OV in patients with CHF, and effects of open‐heart surgery on the OV. Hypothesis OV is an indicator of the severity of CHF, and this abnormal respiratory pattern improves with hemodynamic changes after open‐heart surgery. Methods According to respiratory pattern in the cardiopulmonary exercise testing (CPX) before cardiac surgery, 50 patients with CHF were divided into 14 patients of OV‐positive (OV+) and 36 patients of OV‐negative (OV−). Then, the several indices of CPX before surgey, 1 week and 6 months after surgery were compared between the 2 groups. Results The peak VO2 before surgery was lower in OV+ patients than those in OV− patients (15.3 vs 18.8 m1/min/kg, p < 0.05). One week after surgery, anaerobic threshold (AT) and end‐tidal C02 (ETC02) were lower in OV+ patients than those in OV− patients (AT: 9.5 vs 10,7 ml/min/kg, p < 0.05, ETCO2: 5.3 vs 5.6%, p < 0.05). However, 6 months after surgery, the statistical differences of these CPX parameters between the 2 groups were not found, and OV disappeared in 79% of OV+ patients. Conclusions These data suggest that OV is an indicator of the severity of CHF, and gradually improved with the open‐heart surgery. Copyright © 2010 Wiley Periodicals, Inc.