Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway
Background. Changes in peripheral muscle in heart failure lead to a shift from aerobic to early anaerobic metabolism during exercise leading to ergoreflex overactivation and exaggerated hyperventilation evaluated by the VE/VCO2 slope. Methods. 50 patients (38 males, 59±12 years) performed cardio-pul...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.4061/2011/830279 |
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| author | Jérémie Jaussaud Pierre Blanc Pierre Bordachar Raymond Roudaut Hervé Douard |
| author_facet | Jérémie Jaussaud Pierre Blanc Pierre Bordachar Raymond Roudaut Hervé Douard |
| author_sort | Jérémie Jaussaud |
| collection | DOAJ |
| description | Background. Changes in peripheral muscle in heart failure lead to a shift from aerobic to early anaerobic metabolism during exercise leading to ergoreflex overactivation and exaggerated hyperventilation evaluated by the VE/VCO2 slope. Methods. 50 patients (38 males, 59±12 years) performed cardio-pulmonary exercise test with gaz exchange measurement and echocardiographic evaluation before and 6 months after
CRT. Results. The peak respiratory exchange (VCO2/ VO2) ratio was significantly reduced from 1.16±0.14 to
1.11±0.07 (𝑃<.05) and the time to the anaerobic threshold was increased from 153±82 to
245±140 seconds (𝑃=.01). Peak VO2, VE/VCO2, peak circulatory power and NYHA were improved after CRT (13±4 to16±5 ml/kg/min (𝑃<.05), 45±16 to 39±13 (𝑃<.01), 1805±844 to 2225±1171 mmHg.ml/kg/min (𝑃<.01) and 3±0.35 to 1.88±0.4 (𝑃=.01)). In addition, left ventricular ejection fraction and end-systolic volumes were improved from 24±8 to 29±7% (𝑃<.01) and from 157±69 to 122±55 ml (𝑃<.01). Conclusion. We suggest that CRT leads to an increase in oxidative muscular metabolism and postponed anaerobic threshold reducing exaggerated hyperventilation during exercise. |
| format | Article |
| id | doaj-art-03eaa7514161422994929442b2a2c57a |
| institution | Kabale University |
| issn | 2090-0597 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-03eaa7514161422994929442b2a2c57a2025-02-03T01:09:57ZengWileyCardiology Research and Practice2090-05972011-01-01201110.4061/2011/830279830279Response to Cardiac Resynchronization Therapy: The Muscular Metabolic PathwayJérémie Jaussaud0Pierre Blanc1Pierre Bordachar2Raymond Roudaut3Hervé Douard4Division de Cardiologie Clinique, Hôpital Cardiologique, du Haut Lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, FranceDivision de Cardiologie Clinique, Hôpital Cardiologique, du Haut Lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, FranceDivision de Cardiologie Clinique, Hôpital Cardiologique, du Haut Lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, FranceDivision de Cardiologie Clinique, Hôpital Cardiologique, du Haut Lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, FranceDivision de Cardiologie Clinique, Hôpital Cardiologique, du Haut Lévêque, CHU de Bordeaux, Avenue Magellan, 33600 Pessac, FranceBackground. Changes in peripheral muscle in heart failure lead to a shift from aerobic to early anaerobic metabolism during exercise leading to ergoreflex overactivation and exaggerated hyperventilation evaluated by the VE/VCO2 slope. Methods. 50 patients (38 males, 59±12 years) performed cardio-pulmonary exercise test with gaz exchange measurement and echocardiographic evaluation before and 6 months after CRT. Results. The peak respiratory exchange (VCO2/ VO2) ratio was significantly reduced from 1.16±0.14 to 1.11±0.07 (𝑃<.05) and the time to the anaerobic threshold was increased from 153±82 to 245±140 seconds (𝑃=.01). Peak VO2, VE/VCO2, peak circulatory power and NYHA were improved after CRT (13±4 to16±5 ml/kg/min (𝑃<.05), 45±16 to 39±13 (𝑃<.01), 1805±844 to 2225±1171 mmHg.ml/kg/min (𝑃<.01) and 3±0.35 to 1.88±0.4 (𝑃=.01)). In addition, left ventricular ejection fraction and end-systolic volumes were improved from 24±8 to 29±7% (𝑃<.01) and from 157±69 to 122±55 ml (𝑃<.01). Conclusion. We suggest that CRT leads to an increase in oxidative muscular metabolism and postponed anaerobic threshold reducing exaggerated hyperventilation during exercise.http://dx.doi.org/10.4061/2011/830279 |
| spellingShingle | Jérémie Jaussaud Pierre Blanc Pierre Bordachar Raymond Roudaut Hervé Douard Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway Cardiology Research and Practice |
| title | Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway |
| title_full | Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway |
| title_fullStr | Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway |
| title_full_unstemmed | Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway |
| title_short | Response to Cardiac Resynchronization Therapy: The Muscular Metabolic Pathway |
| title_sort | response to cardiac resynchronization therapy the muscular metabolic pathway |
| url | http://dx.doi.org/10.4061/2011/830279 |
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