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- Title
Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway.
- Authors
Jaussaud, Jérémie; Blanc, Pierre; Bordachar, Pierre; Roudaut, Raymond; Douard, Hervé
- Abstract
Background. Changes in peripheral muscle in heart failure lead to a shift from aerobic to early anaerobicmetabolism during exercise leading to ergoreflex overactivation and exaggerated hyperventilation evaluated by the VE/VCO2 slope. Methods. 50 patients (38 males, 59 ± 12 years) performed cardio-pulmonary exercise test with gaz exchange measurement and echocardiographic evaluation before and 6 months after CRT. Results. The peak respiratory exchange (VCO2/ VO2) ratio was significantly reduced from 1.16±0.14 to 1.11±0.07 (P < .05) and the time to the anaerobic threshold was increased from 153±82 to 245±140 seconds (P = .01). Peak VO2, VE/VCO2, peak circulatory power and NYHA were improved after CRT (13±4 to16±5ml/kg/min(P < .05), 45 ± 16 to 39 ± 13 (P < .01), 1805 ± 844 to 2225 ± 1171 mmHg.ml/kg/min (P < .01) and 3 ± 0.35 to 1.88 ± 0.4 (P = .01)). In addition, left ventricular ejection fraction and end-systolic volumes were improved from 24 ± 8 to 29 ± 7% (P < .01) and from 157 ± 69 to 122 ± 55 ml (P < .01). Conclusion. We suggest that CRT leads to an increase in oxidative muscular metabolism and postponed anaerobic threshold reducing exaggerated hyperventilation during exercise.
- Subjects
HEART failure; HYPERVENTILATION; ECHOCARDIOGRAPHY; PULMONARY gas exchange; RESPIRATION; METABOLISM
- Publication
Cardiology Research & Practice, 2011, p1
- ISSN
2090-8016
- Publication type
Article
- DOI
10.4061/2011/830279