Dynamics of oxygen uptake for submaximal exercise and recovery in patients with chronic heart failure

K. E. Sietsema*, I. Ben-Dov, Yu Zhang Yong Yu Zhang, C. Sullivan, K. Wasserman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

150 Scopus citations

Abstract

Study design and objectives: Attainment of a steady state for oxygen uptake (V̇O2) during constant work rate exercise has been reported to take longer for patients with chronic heart failure (CHF) compared with normal. The steady state is also delayed in normal subjects during high-intensity exercise compared with moderate exercise, however, and the delay correlates with the degree of associated lactic acidosis. To determine whether prolonged kinetics of V̇O2 are attributable solely to the reduction of exercise capacity in CHF, V̇O2 kinetics were compared for patients with CHF and normal subjects, both for exercise of matched absolute work rate and for matched relative work intensity. Subjects: Eighteen men with CHF and 10 normal men. Methods and results: Subjects performed 6 min of constant work rate cycle ergometry with breath-by-breath measurement of V̇O2. Patients were studied using 25 W, and a work rate midway between the lactic acidosis threshold and maximal capacity (50 percent Δ). Normal subjects were tested similarly, and also at a work rate matched to the patients' average 50 percent Δ work rate. The V̇O2 kinetics were characterized by the mean response time (MRT) to attain the 6 min V̇O2 value. Rates of recovery of V̇O2 were analyzed for 2 min following exercise. For the same absolute work rate, V̇O2 MRTs were significantly longer for patients than controls (25 W, 67 ± 26 vs 37 ± 25 s; ~60 W, 87 ± 20 vs 54 ± 27 s), but there was no significant difference in V̇O2 MRT between the two groups at a matched intensity of 50 perceng Δ (87 ± 20 vs 81 ± 18 s). However, the decrease in V̇O2 during 2 min of recovery was slower for the patients on all comparisons, even for matched exercise intensity. Conclusion: The V̇O2 dynamics for submaximal exercise are slowed in CHF. The slower dynamics are not entirely accounted for by the relatively higher intensity of a given work rate, since delayed recovery is evident even at a matched relative work intensity. Exercise intolerance in CHF is characterized not only by decreased maximal exercise capacity, but also by slower adaptations to and from submaximal levels of exercise.

Original languageEnglish
Pages (from-to)1693-1700
Number of pages8
JournalChest
Volume105
Issue number6
DOIs
StatePublished - 1994
Externally publishedYes

Funding

FundersFunder number
National Heart, Lung, and Blood InstituteR01HL011907

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