The presence of impaired chronotropic competence is a major predictor of poor training response in CHF patients with sinus rhythm.

No abstract

Exertional oscillatory ventilation (EOV) is an ominous prognostic sign in chronic heart failure (CHF), but little is known about the success of specific therapeutic interventions.Our aim was to study the impact of an exercise training on exercise capacity and cardiopulmonary adaptation in stable CHF patients with left ventricular systolic dysfunction and EOV.96 stable CHF patients with EOV were included in a retrospective analysis (52 training versus 44 controls). EOV was defined as follows: 1) three or more oscillatory fluctuations in minute ventilation (V9E) during exercise; 2) regular oscillations; and 3) minimal average ventilation amplitude o5 L.EOV disappeared in 37 (71.2%) out of 52 patients after training, but only in one (2.3%) out of 44 without training (p,0.001). The decrease of EOV amplitude correlated with changes in end-tidal carbon dioxide tension (r5 -0.60, p,0.001) at the respiratory compensation point and V9E/carbon dioxide production (V9CO 2 ) slope (r50.50, p,0.001). Training significantly improved resting values of respiratory frequency (fR), V9E, tidal volume (VT) and V9E/V9CO 2 ratio. During exercise, V9E and VT reached significantly higher values at the peak, while fR and V9E/V9CO 2 ratio were significantly lower at submaximal exercise. No change was noted in the control group.Exercise training leads to a significant decrease of EOV and improves ventilatory efficiency in patients with stable CHF.

In contrast to BNP and copeptin, MR-proADM is not immediately affected by a maximal exercise test. MR-proADM but not copeptin is at least as good an indicator of low peak VO2 and CPET parameters reflecting an impaired cardiac output reserve, ventilatory efficiency and diffusion capacity as BNP, and thereby a global cardiopulmonary stress marker.