Journal of Applied Physiology
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J Appl Physiol 92: 1409-1416, 2002. First published November 23, 2001; doi:10.1152/japplphysiol.00724.2001
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Vol. 92, Issue 4, 1409-1416, April 2002

Exercise hyperpnea in chronic heart failure: relationships to lung stiffness and expiratory flow limitation

Piergiuseppe Agostoni1, Riccardo Pellegrino2, Cristina Conca1, Joseph R. Rodarte3, and Vito Brusasco4

1 Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia dell' Università degli Studi di Milano, IRCCS, Centro di Studio per le Ricerche Cardiovascolari del CNR, 20138 Milan, Italy; 2 Fisiopatologia Respiratoria e Cardiologia, Azienda Ospedaliera S. Croce e Carle, 12100 Cuneo, Italy; 3 Pulmonary Section, Baylor College of Medicine, Houston, Texas 77030; and 4 Cattedra di Fisiopatologia Respiratoria, DISM, Università di Genova, 16132 Genova, Italy

The changes in breathing pattern and lung mechanics in response to incremental exercise were compared in 14 subjects with chronic heart failure and 15 normal subjects. In chronic heart failure subjects, exercise hyperpnea was achieved by increasing breathing frequency more than tidal volume. The rate of increase in breathing frequency with carbon dioxide output was inversely correlated (r = -0.61, P < 0.05) with dynamic lung compliance measured at rest, but not with static lung compliance either at rest or at maximum exercise. Although decrease in expiratory flow reserve near functional residual capacity in chronic heart failure occurred earlier with exercise than in the normal subjects (P < 0.01), it was not correlated with changes in breathing pattern or occurrence of tachypnea. Tachypnea was achieved in chronic heart failure subjects with an increase in duty cycle because of a greater than normal decrease in expiratory time with exercise. We conclude that in chronic heart failure preexisting increase in lung stiffness plays a significant role in causing tachypnea during exercise. The results of the present study do not support the hypothesis that dynamic compression of the airways downstream from the flow-limiting segment occurring during exercise contributes to hyperpnea.

static and dynamic lung compliance; breathing pattern; flow-volume curves; expiratory flow reserve


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