Paradoxical Potentiation of Exercise Hyperpnea in Congestive Heart Failure Contradicts Sherrington Chemoreflex Model and Supports a Respiratory Optimization Model

  • Chung Tin
  • Karlman Wasserman
  • Neil S. Cherniack
  • Chi-Sang Poon
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 669)


Congestive heart failure (CHF) patients suffer decreased exercise tolerance, yet they demonstrate an augmented ventilatory response to exercise such that PaCO2 remains normal (isocapnic) from rest to maximal exercise in the face of increased pulmonary dead space (Fig. 1). On the other hand, the effect of a large external dead space is hypercapnic instead of isocapnic. This discrepancy suggests that external dead space and pulmonary dead space may exert distinct influences on control of breathing. These paradoxical clinical phenomena are at variance with the conventional chemoreflex model (Johnson 2001), but appear to be consistent with the predictions of the optimization model (Poon 2001; Poon, Tin et al. 2007).



Supported by National Institutes of Health grants HL072849. C. Tin is an American Heart Association Predoctoral Fellow.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Chung Tin
    • 1
  • Karlman Wasserman
    • 2
  • Neil S. Cherniack
    • 3
  • Chi-Sang Poon
    • 4
  1. 1.Department of Mechanical EngineeringM.I.T.CambridgeUSA
  2. 2.Department of Medicine, Division of Respiratory and Critical Care Physiology and MedicineHarbor-UCLA Medical CenterTorranceUSA
  3. 3.New Jersey Medical SchoolUniversity of Medicine and Dentistry of New JerseyNew JerseyUSA
  4. 4.Harvard-MIT Division of Health Sciences and TechnologyM.I.TCambridgeUSA

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