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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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