Carbon dioxide elimination pattern at cardiopulmonary exercise testing in patients with low ejection fraction value
https://doi.org/10.18093/0869-0189-2019-29-6-647-653
Abstract
The objective of this study was to evaluate partial pressure of end tidal carbon dioxide (PetCO2) over time on exertion (E) and its predictive value in evaluation of risk of unfavorable outcome in patients with low ejection fraction (EF) value.
Materials and Methods. Patients (n = 53) with pronounced chronic heart failure (CHF), included in heart transplantation waiting list, were enrolled in the prospective study. All patients underwent cardiopulmonary exercise testing (CPET). Mortality or INCOR left ventricle bypass system implantation according to vital indications within 1 year of follow-up were evaluated as an end-point.
Results. Patients with CHF and low EF were characterized by low parameters of E tolerance and peak oxygen consumption (10.4 (9.6–11.7) ml/min/kg). The average PetCO2 level by group was 30.4 (28.3–33.0) mm Hg; in 32% of patients this value decreased or did not change in CPET compared with that in resting state. The significant relationship between increased risk of unfavorable outcome within 1 year of follow-up with low baseline PetCO2 value (odds ratio (OR) – 0.22 (0.05–0.87); p = 0.020) and absence of its increment in PE (OR – 0.16 (0.10–0.54); p = 0.009) was observed.
Conclusion. The significant predictive factors of unfavorable outcome within 1 year of follow-up in patients with pronounced CHF and low EF include PetCO2 value in resting state, as well as PetCO2 change over time after E challenge.
About the Authors
O. V. Kamenskaya
Federal State Budgetary Institution National Medical Research Center named after Academician E. N. Meshalkin of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Oksana V. Kamenskaya, Doctor of Medical Sciences, Senior Research Scientist in Clinical Physiology Group of Anaesthesiology and Reanimation Center
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
tel.: (383) 347-60-66
I. Yu. Loginova
Federal State Budgetary Institution National Medical Research Center named after Academician E. N. Meshalkin of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Irina Yu. Loginova, Candidate of Biological Sciences, Senior Research Scientist in Clinical Physiology Group of Anaesthesiology and Reanimation Center
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
tel.: (383) 347-60-66
A. M. Chernyavskiy
Federal State Budgetary Institution National Medical Research Center named after Academician E. N. Meshalkin of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Aleksandr M. Chernyavskiy, Doctor of Medical Sciences, Professor, Honoured Scientist of the Russian Federation, Head of Center for Surgery of Aorta, Coronary and Peripheric Arteries
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
tel.: (383) 347-60-40
D. V. Doronin
Federal State Budgetary Institution National Medical Research Center named after Academician E. N. Meshalkin of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dmitriy V. Doronin, Candidate of Medical Sciences, cardiologist in the Department of Cardiac Surgery of Aorta and Coronary Arteries
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
tel.: (383) 347-60-66
V. V. Lomivorotov
Federal State Budgetary Institution National Medical Research Center named after Academician E. N. Meshalkin of Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Vladimir V. Lomivorotov, Doctor of Medical Sciences, Associate Member of the Russian Academy of Sciences, Head of Center of Anaesthesiology and Reanimation Center
ul. Rechkunovskaya 15, Novosibirsk, 630055, Russia
tel.: (383) 347-60-66
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For citations:
Kamenskaya O.V., Loginova I.Yu., Chernyavskiy A.M., Doronin D.V., Lomivorotov V.V. Carbon dioxide elimination pattern at cardiopulmonary exercise testing in patients with low ejection fraction value. PULMONOLOGIYA. 2019;29(6):647-653. (In Russ.) https://doi.org/10.18093/0869-0189-2019-29-6-647-653
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