Chest
Respiratory Muscle Strength in Congestive Heart Failure
Section snippets
Patients
Sixteen ambulatory outpatients with severe chronic CHF were studied, as were 18 AMNs (Table 1). Mean age (±SD) of the patients was 61±9 years, and that of the AMNs was 61±5 years. Ten patients had CAD, four had congestive ICM and one each had RhHD, IHSS, and had undergone mitral valve replacement. Of the ten patients with CAD, two had had coronary bypass surgery 12 and 13 years earlier. The mean LVEF by gated nuclear angiogram (MUGA) for the group with CHF was 26±7 percent; six of the 16 were
Results
Results are summarized in Tables 1 and 2. Both FVC and FEV1 were significantly reduced in the group with CHF, a fact attributable mostly to pulmonary congestion and edema. Although the subjects with CHF were mildly restricted, the FEVl/FVC% was not significantly different between the group with CHF and the normal group, attesting to the absence of significant coexisting obstructive pulmonary disease in the patients with CHF.
Handgrip strength was moderately reduced (31.5±6.4 kg) in the group
Discussion
We have shown that maximal static respiratory pressures were significantly decreased in a group of patients with severe biventricular CHF. In five patients (Table 1), Pimax values at FRC were between 20 and 30 cm HaO, low values which in a critical care setting could cause concern over whether a patient might require mechanical ventilation, yet these patients were ambulatory, although dyspneic. These observations suggest that many such patients may be functioning precariously close to
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Cited by (0)
Supported by the VA Research Service.
Manuscript received January 22; revision accepted May 1.
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Associate Professor of Medicine.
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Pulmonary Fellow.
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Professor of Medicine.
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Engineer, VA Research Service.