Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease
Background: Autonomic dysfunction (AD) and cardio-pulmonary exercise testing (CPET) parameters have been associated with masked heart failure with preserved ejection fraction (HFpEF) in the general population. Their clinical significance for masked HFpEF in chronic obstructive pulmonary disease (COPD...
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| Format: | Article |
| Language: | Bulgarian |
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Pensoft Publishers
2020-12-01
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| Series: | Българска кардиология |
| Subjects: | |
| Online Access: | https://journal.bgcardio.org/article/58373/download/pdf/ |
| _version_ | 1827614536345059328 |
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| author | Zheina Cherneva Radostina Cherneva |
| author_facet | Zheina Cherneva Radostina Cherneva |
| author_sort | Zheina Cherneva |
| collection | DOAJ |
| description | Background: Autonomic dysfunction (AD) and cardio-pulmonary exercise testing (CPET) parameters have been associated with masked heart failure with preserved ejection fraction (HFpEF) in the general population. Their clinical significance for masked HFpEF in chronic obstructive pulmonary disease (COPD) is however elusive. Aim: The aim of the study was to determine the prevalence, correlation and clinical significance of AD and CPET with masked HFpEF, in non-severe COPD patients, complaining of exertional dyspnea, without clinically overt cardio-vascular (CV) comorbidities (ischaemic heart disease, heart failure, uncontrolled arterial hypertension). Methods and results: We applied CPET and echocardiography in 68 COPD subjects. Echocardiography was performed before CPET and 1-2 minutes after peak exercise. Patients were divided into two groups: patients with and without masked HFpEF. Peak E/e’ – 15 was applied as a cut-off. Chronotropic incompetence (CI) was assumed if both failure to reach the target heart rate (HR) on exercise and diminished heart rate reserve < 80% occurred. Abnormal HR recovery (HRR) was taken if the decline is less than 12 beats within the first minute after exercise cessation. Univariate regression showed association between masked HFpEF, HRR, ’VO2, ’VO2 at AT, oxygen pulse and ’VE/’VCO2 slope. The multivariate regression demonstrated HRR as the only independent predictor of masked HFpEF – OR 10.28; 95% CI (3.55-29.80). Conclusion: Abnormal HRR is the only independent predictor of masked HFpEF in non-severe COPD patients. Despite of being associated with masked HFpEF, the lower ’VO2, lower oxygen pulse, higher ’VE/’VCO2 slope and lower exercise load seem to be the consequences, rather than the triggers for it. |
| first_indexed | 2024-03-09T08:57:16Z |
| format | Article |
| id | doaj.art-7e210cb7694a441297552b8b96a659c4 |
| institution | Directory Open Access Journal |
| issn | 2683-1015 |
| language | Bulgarian |
| last_indexed | 2024-03-09T08:57:16Z |
| publishDate | 2020-12-01 |
| publisher | Pensoft Publishers |
| record_format | Article |
| series | Българска кардиология |
| spelling | doaj.art-7e210cb7694a441297552b8b96a659c42023-12-02T12:48:08ZbulPensoft PublishersБългарска кардиология2683-10152020-12-01264465410.3897/bgcardio.26.e5837358373Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary diseaseZheina Cherneva0Radostina Cherneva1Medical Institute of the Ministry of InteriorMedical University - SofiaBackground: Autonomic dysfunction (AD) and cardio-pulmonary exercise testing (CPET) parameters have been associated with masked heart failure with preserved ejection fraction (HFpEF) in the general population. Their clinical significance for masked HFpEF in chronic obstructive pulmonary disease (COPD) is however elusive. Aim: The aim of the study was to determine the prevalence, correlation and clinical significance of AD and CPET with masked HFpEF, in non-severe COPD patients, complaining of exertional dyspnea, without clinically overt cardio-vascular (CV) comorbidities (ischaemic heart disease, heart failure, uncontrolled arterial hypertension). Methods and results: We applied CPET and echocardiography in 68 COPD subjects. Echocardiography was performed before CPET and 1-2 minutes after peak exercise. Patients were divided into two groups: patients with and without masked HFpEF. Peak E/e’ – 15 was applied as a cut-off. Chronotropic incompetence (CI) was assumed if both failure to reach the target heart rate (HR) on exercise and diminished heart rate reserve < 80% occurred. Abnormal HR recovery (HRR) was taken if the decline is less than 12 beats within the first minute after exercise cessation. Univariate regression showed association between masked HFpEF, HRR, ’VO2, ’VO2 at AT, oxygen pulse and ’VE/’VCO2 slope. The multivariate regression demonstrated HRR as the only independent predictor of masked HFpEF – OR 10.28; 95% CI (3.55-29.80). Conclusion: Abnormal HRR is the only independent predictor of masked HFpEF in non-severe COPD patients. Despite of being associated with masked HFpEF, the lower ’VO2, lower oxygen pulse, higher ’VE/’VCO2 slope and lower exercise load seem to be the consequences, rather than the triggers for it.https://journal.bgcardio.org/article/58373/download/pdf/chronotropic intolerancecardio-pulmonary exercis |
| spellingShingle | Zheina Cherneva Radostina Cherneva Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease Българска кардиология chronotropic intolerance cardio-pulmonary exercis |
| title | Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease |
| title_full | Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease |
| title_fullStr | Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease |
| title_full_unstemmed | Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease |
| title_short | Autonomic dysfunction, cardio-pulmonary parameters and masked heart failure in non-severe chronic obstructive pulmonary disease |
| title_sort | autonomic dysfunction cardio pulmonary parameters and masked heart failure in non severe chronic obstructive pulmonary disease |
| topic | chronotropic intolerance cardio-pulmonary exercis |
| url | https://journal.bgcardio.org/article/58373/download/pdf/ |
| work_keys_str_mv | AT zheinacherneva autonomicdysfunctioncardiopulmonaryparametersandmaskedheartfailureinnonseverechronicobstructivepulmonarydisease AT radostinacherneva autonomicdysfunctioncardiopulmonaryparametersandmaskedheartfailureinnonseverechronicobstructivepulmonarydisease |