Proportional assist ventilation improves leg muscle reoxygenation after exercise in heart failure with reduced ejection fraction
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Universidade Federal de São Carlos
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Background: Respiratory muscle unloading through proportional assist ventilation (PAV) may enhance leg oxygen delivery, thereby speeding off-exercise oxygen uptake (V.O2) kinetics in patients with heart failure with reduced left ventricular ejection fraction (HFrEF). Methods: Ten male patients (HFrEF = 26 ± 9%, age 50 ± 13 years, and body mass index 25 ± 3 kg m2) underwent two constant work rate tests at 80% peak of maximal cardiopulmonary exercise test to tolerance under PAV and sham ventilation. Post-exercise kinetics of V.O2, vastus lateralis deoxyhemoglobin ([deoxy-Hb + Mb]) by near-infrared spectroscopy, and cardiac output (QT) by impedance cardiography were assessed. Results: PAV prolonged exercise tolerance compared with sham (587 ± 390 s vs. 444 ± 296 s, respectively; p = 0.01). PAV significantly accelerated V.O2 recovery (τ = 56 ± 22 s vs. 77 ± 42 s; p < 0.05), being associated with a faster decline in Δ[deoxy-Hb + Mb] and QT compared with sham (τ = 31 ± 19 s vs. 42 ± 22 s and 39 ± 22 s vs. 78 ± 46 s, p < 0.05). Faster off-exercise decrease in QT with PAV was related to longer exercise duration (r = −0.76; p < 0.05). Conclusion: PAV accelerates the recovery of central hemodynamics and muscle oxygenation in HFrEF. These beneficial effects might prove useful to improve the tolerance to repeated exercise during cardiac rehabilitation.
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SILVA, Audrey Borghi; GOULART, Cássia da Luz; CARRASCOSA, Cláudia R.; OLIVEIRA, Cristino Carneiro; BERTON, Danilo Cortozi; ALMEIDA, Dirceu Rodrigues de; NERY, Luiz Eduardo; ARENA, Ross; NEDER, José Alberto. Proportional assist ventilation improves leg muscle reoxygenation after exercise in heart failure with reduced ejection fraction. Repositório Institucional da UFSCar, 2021. Dataset. Disponível em: https://repositorio.ufscar.br/handle/20.500.14289/15603.
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