Central Chemoreceptor Sensitivity Is Not Enhanced in Contemporary Patients With Chronic Systolic Heart Failure Receiving Optimal Treatment

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• 作者：Bartłomiej Paleczny ; PhD¹ ; ² ; ^{bartlomiej.paleczny@gmail.com} ; Martyna Olesińska ; MD ; PhD² ; Agnieszka Siennicka ; PhD¹ ; ² ; Piotr Niewiński ; MD ; PhD² ; Ewa A. Jankowska ; MD ; PhD² ; ³ ; Beata Ponikowska ; MD ; PhD¹ ; Waldemar Banasiak ; MD ; PhD² ; Stephan Von Haehling ; MD ; PhD⁴ ; Stefan D. Anker ; MD ; PhD⁴ ; Piotr Ponikowski ; MD ; PhD² ; ⁵
• 关键词：Central chemoreflex ; hypercapnic ventilatory response ; heart failure
• 刊名：Journal of Cardiac Failure
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：23
• 期：1
• 页码：83-87
• 全文大小：114 K
• 卷排序：23

文摘

Clinical and prognostic consequences of enhanced central chemosensitivity in the contemporary optimally treated patients with chronic heart failure (CHF) are unknown.Methods and ResultsWe studied central chemosensitivity (defined as hypercapnic ventilatory response [HCVR; L/min/mmHg]) in 161 CHF patients (mean left ventricular ejection fraction [LVEF] 31 ± 6%, all receiving a combination of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker) and 55 sex- and age-matched healthy controls. HCVR did not differ between CHF patients and controls (median 0.63 vs 0.57 L/min−1/mmHg−1, P = .76). When the CHF patients were divided into tertiles according to their HCVR values, there were no significant differences in clinical characteristics (except for ischemic etiology, which was more frequent in those with the highest HCVR), results of the cardiopulmonary exercise testing, and indices of heart rate variability. During the follow-up (median 28 months, range 1–48 months, ≥15 months in all survivors), 21 patients died. HCVR was not related to survival in the Cox proportional hazards analysis.ConclusionsCentral chemosensitivity is not enhanced in contemporary, optimally treated CHF patients and its assessment does not provide significant clinical or prognostic information.