Cardiopulmonary exercise testing for identification of patients with hyperventilation syndrome
Language English Country United States Media electronic-ecollection
Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
PubMed
31013331
PubMed Central
PMC6478351
DOI
10.1371/journal.pone.0215997
PII: PONE-D-19-00923
Knihovny.cz E-resources
- MeSH
- Adult MeSH
- Dyspnea physiopathology MeSH
- Hyperventilation diagnosis physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Carbon Dioxide metabolism MeSH
- Oxygen Consumption physiology MeSH
- Heart Failure physiopathology MeSH
- Exercise Tolerance MeSH
- Exercise Test * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
- Names of Substances
- Carbon Dioxide MeSH
INTRODUCTION: Measurement of ventilatory efficiency, defined as minute ventilation per unit carbon dioxide production (VE/VCO2), by cardiopulmonary exercise testing (CPET) has been proposed as a screen for hyperventilation syndrome (HVS). However, increased VE/VCO2 may be associated with other disorders which need to be distinguished from HVS. A more specific marker of HVS by CPET would be clinically useful. We hypothesized ventilatory control during exercise is abnormal in patients with HVS. METHODS: Patients who underwent CPET from years 2015 through 2017 were retrospectively identified and formed the study group. HVS was defined as dyspnea with respiratory alkalosis (pH >7.45) at peak exercise with absence of acute or chronic respiratory, heart or psychiatric disease. Healthy patients were selected as controls. For comparison the Student t-test or Mann-Whitney U test were used. Data are summarized as mean ± SD or median (IQR); p<0.05 was considered significant. RESULTS: Twenty-nine patients with HVS were identified and 29 control subjects were selected. At rest, end-tidal carbon dioxide (PETCO2) was 27 mmHg (25-30) for HVS patients vs. 30 mmHg (28-32); in controls (p = 0.05). At peak exercise PETCO2 was also significantly lower (27 ± 4 mmHg vs. 35 ± 4 mmHg; p<0.01) and VE/VCO2 higher ((38 (35-43) vs. 31 (27-34); p<0.01)) in patients with HVS. In contrast to controls, there were minimal changes of PETCO2 (0.50 ± 5.26 mmHg vs. 6.2 ± 4.6 mmHg; p<0.01) and VE/VCO2 ((0.17 (-4.24-6.02) vs. -6.6 (-11.4-(-2.8)); p<0.01)) during exercise in patients with HVS. The absence of VE/VCO2 and PETCO2 change during exercise was specific for HVS (83% and 93%, respectively). CONCLUSION: Absence of VE/VCO2 and PETCO2 change during exercise may identify patients with HVS.
Department of Anesthesiology and Intensive Care St Anne´s University Hospital Brno Czech Republic
Department of Cardiovascular Diseases Mayo Clinic Rochester MN United States of America
Department of Respiratory Diseases University Hospital Brno Brno Czech Republic
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