Congestive Heart FailureLack of effect of increased inspired oxygen concentrations on maximal exercise capacity or ventilation in stable heart failure☆
Section snippets
Patient group
Seventeen men with New York Heart Association functional class II to III heart failure symptoms and severe left ventricular dysfunction (determined by a radionuclide ejection fraction <35%) were considered for this study. Patients were to be excluded if they experienced ventricular arrhythmias, hypotension, chest pain, ST-segment depression, or claudication during exercise testing, or if they were taking a β blocker. One patient was excluded during the practice exercise test because of chest
Baseline measurements
Patients did not have evidence of obstructive or restrictive pulmonary disease (Table I). Resting measurements of heart rate, mean arterial blood pressure, and arterial and venous lactate were not different between the 2 tests. During baseline exercise testing on room air, the average peak oxygen uptake was 14.5 ± 3.2 ml/min/kg, associated with a respiratory exchange ratio of 1.11 ± 0.07. Thirteen of the patients stopped exercise because of fatigue and 3 because of dyspnea. All patients had the
Discussion
In this double blind, randomized, controlled study, we failed to demonstrate any benefit in exercise performance with the administration of 60% oxygen to patients with chronic stable heart failure. Under conditions of normoxia (21%) and hyperoxia (60%), maximal exercise time, ventilation, and leg oxygen uptake were virtually identical.
There are several explanations for the failure of hyperoxia to be effective. First, the administration of 60% oxygen did not result in a significant change in
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Cited by (25)
Effect of increased inspired oxygen on exercise performance in patients with heart failure and normal ejection fraction
2018, International Journal of CardiologyCitation Excerpt :Moore and colleagues reported a dose dependent increase in exercise time from 548 ± 275 s on room air to 632 ± 288 s with FiO2 of 50% in 12 patients with HeFREF during resistance cycling on a stationary bike to maximum capacity (workload was increased by 15 W at 2-min intervals) [12]. In contrast, Russell and colleagues found no effect of increasing Fio2 to 60% on exercise time compared to 21% Fio2 during symptom limiting resistance cycling on a stationary bike (2-minute resting period followed by increasing workloads of 25 W every 3 min) in 16 patients with LVEF <35% [18]. Restrick found no effect of oxygen delivered at 4 l/min on 6 minute walk test distance in 12 patients with stable chronic heart failure [19].
A possible role for systemic hypoxia in the reactive component of pulmonary hypertension in heart failure
2013, Journal of Cardiac FailureCitation Excerpt :Despite the prevailing view that SaO2 and PaO2 are maintained at or even above normal values at rest and during exercise in HF patients,12–15 there is evidence that transient but significant periods of arterial desaturation (SaO2 <90% for > 5 s) that are greater in frequency, magnitude, and total duration (>24 h) compared with healthy subjects can occur in HF patients.16 In addition, O2 supplementation of inspired gas has been shown to increase SaO2, reduce perceived exertion, and increase exercise time in HF patients,17 although this is not a consistent finding.21 Moreover, it is probable that there is a reduction in both PaO2 and PvO2 in HF patients that is masked by a somewhat normal/low-normal SaO2.22
What Interventions Are Effective for Managing Dyspnea in Heart Failure?
2012, Evidence-Based Practice of Palliative MedicineEnhanced ability of hemoglobin to carry oxygen by salidroside
2007, Electrochemistry CommunicationsConsensus statement: Palliative and supportive care in advanced heart failure
2004, Journal of Cardiac FailureCitation Excerpt :All patients with advanced HF should be evaluated and, if indicated, treated for sleep-disordered breathing. Oxygen supplementation does not benefit exercise performance or function in HF,39 though it is thought to improve dyspnea.40 Opioids may be effective in relieving dyspnea,41 but little is known about the physiologic effects of opioids in advanced HF.
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This study was supported by Claude D. Pepper-GRTC Grant AG-11268-04, National Institutes of Health, Bethesda, Maryland.