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Q J Med 1992; 83: 523-531
© 1992 Association of Physicians

research-article

The Ventilatory Cost of Exercise Compared in Chronic Heart Failure and Chronic Renal Anaemia

NP LEWIS, IC MACDOUGALL*, N WILLIS{dagger} and AH HENDERSON

Department of Cardiology, University of Wales College of Medicine Heath Park, Cardiff, CF4 4XN *Institute of Nephrology, Cardiff Royal Infirmary Newport Road, Cardiff {dagger}Department of Medical Biochemistry, University Hospital of Wales Heath Park, Cardiff, CF4 4XW, UK

Accepted for publication 23 April 1992.

The cardiorespiratory responses to maximal treadmill exercise were compared in matched groups of patients with chronic renal anaemia or treated chronic heart failure, and in normal controls. Exercise capacity was similarly reduced in both patient groups compared to normal controls, the raised respiratory exchange ratio at peak exercise implying anaerobic metabolism due to limited oxygen delivery in heart failure and limited oxygen carrying capacity in anaemia. Minute ventilation (VF) was related linearly to minute CO2 production (VCO2) in all subjects (each r>0.92) from all three groups. The slope of the VE/VCO2 relationship was normal in anaemia but steeper in heart failure, reflecting ventilation/perfusion mismatching in chronic heart failure.


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