Ventilatory Efficiency during Exercise in Healthy Subjects
- 1 December 2002
- journal article
- research article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 166 (11), 1443-1448
- https://doi.org/10.1164/rccm.2202033
Abstract
When evaluating dyspnea in patients with heart or lung disease it is useful to measure the quantity of ventilation needed to eliminate metabolically produced CO2 (i.e., the ventilatory efficiency). Mathematically, the relationship between ventilation (V̇E) and CO2 output is determined by the arterial CO2 pressure and the physiologic dead space–tidal volume ratio. We decided to determine how age, sex, size, fitness, and the type of ergometer influenced ventilatory efficiency in normal subjects. Three methods were compared for expressing this relationship: (1) the V̇E versus CO2 output slope below the ventilatory compensation point, commonly used by cardiologists for estimating the severity of heart failure; (2) the V̇E/CO2 output ratio at the anaerobic threshold, commonly used by pulmonologists; and (3) the lowest V̇E/CO2 output ratio during exercise, the latter parameter not previously reported. We studied 474 healthy adults, between 17 and 78 years of age during incremental cycle and treadmill cardiopulmonary exercise tests at three test sites, correcting the total V̇E for the equipment dead space. The lowest V̇E/CO2 output ratio was insignificantly different from the ratio at the anaerobic threshold, less variable than that for the slope relationship, and unaffected by the site, ergometer, and gas exchange measurement systems. The regression equation for the lowest V̇E/CO2 output ratio was 27.94 + 0.108 × age + (0.97 = F, 0.0 = M) − 0.0376 × height, where age is in years and height is in centimeters. We conclude that the lowest V̇E/CO2 output ratio is the preferred noninvasive method to estimate ventilatory inefficiency.Keywords
This publication has 23 references indexed in Scilit:
- Impairment of Ventilatory Efficiency in Heart FailureCirculation, 2000
- Pathophysiology of Activity Limitation in Patients With Interstitial Lung DiseaseChest, 1996
- Importance of abnormal lung perfusion in excessive exercise ventilation in chronic heart failureAmerican Heart Journal, 1993
- Exercise hyperventilation chronic congestive heart failure, and its relation to functional capacity and hemodynamicsThe American Journal of Cardiology, 1992
- Normal Values and Ranges for Ventilation and Breathing Pattern at Maximal ExerciseChest, 1991
- A critical threshold of exercise capacity in the ventilatory response to exercise in heart failure.Heart, 1991
- An Algorithm for the Interpretation of Cardiopulmonary Exercise TestsChest, 1990
- Coupling of Ventilation and CO2 Production during Exercise in ChildrenPediatric Research, 1987
- Oxygen utilization and ventilation during exercise in patients with chronic cardiac failure.Cell Metabolism, 1982
- The relation of ventilation to metabolic rate during moderate exercise in manEuropean Journal of Applied Physiology, 1980