Interaction of Respiratory Muscles and Circulation in Heart Failure

  • T. Vassilakopoulos
  • C. Roussos
  • S. Zakynthinos
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1999)

Abstract

According to Braunwald’s textbook of heart diseases [1], heart failure is the pathophysiological state in which an abnormality of cardiac function is responsible for failure of the heart to pump blood at a rate commensurate with the requirements of metabolizing tissues, or to do so only from elevated filling pressures. The clinical manifestations of heart failure, i.e., fatigue and dyspnea which limit exercise/activity tolerance, are well recognized by physicians. The consequencies of heart failure on respiratory muscle function though significant are not usually appreciated. These consequencies will be the subject of the first part of this chapter.

Keywords

Fatigue Ischemia Adenosine Cardiomyopathy Cardiol 

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References

  1. 1.
    Braunwald E (1992) Pathophysiology of heart failure. In: Braunwald E (ed) Heart Disease. A Textbook of Cardiovascular Medicine 4th edition. W. B. Saunders Co, Philadelphia, pp 393–418.Google Scholar
  2. 2.
    Hammond MD, Bauer KA, Sharp JT, Rocha RD (1990) Respiratory muscle strength in congestive heart failure. Chest 98:1091–1094.PubMedCrossRefGoogle Scholar
  3. 3.
    Mancini DM, Ferraro N, Nazzaro D, Chance B, Wilson JR (1991) Respiratory muscle deoxygenation during exercise in patients with heart failure demonstrated with near-infrared spectroscopy. J Am Coll Cardiol 18:492–498.PubMedCrossRefGoogle Scholar
  4. 4.
    Mancini DM, Henson D, LaManca J, Levine S (1992) Respiratory muscle function and dyspnea in patients with chronic congestive heart failure. Circulation 86:909–918.PubMedCrossRefGoogle Scholar
  5. 5.
    McParland C, Krishnan B, Wang Y, Gallagher CG (1992) Inspiratory muscle weakness and dyspnea in chronic heart failure. Am Rev Respir Dis 146:467–472.PubMedGoogle Scholar
  6. 6.
    Nishimura Y, Maeda H, Tanaka K, Nakamura H, Hashimoto Y, Yokoyama M (1994) Respiratory muscle strength and hemodynamics in chronic heart failure. Chest 105:355–359.PubMedCrossRefGoogle Scholar
  7. 7.
    Hamilton AL, Killian KJ, Summers E, Jones NL (1995) Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. Am J Respir Crit Care Med 152:2021–2031.PubMedGoogle Scholar
  8. 8.
    Mancini DM, Henson D, LaManca J, Levine S (1994) Evidence of reduced respiratory muscle endurance in patients with heart failure. J Am Coll Cardiol 24:972–981.PubMedCrossRefGoogle Scholar
  9. 9.
    Ambrosino N, Opasich C, Crotti P, Cobelli F, Tavazzi L, Rampulla C (1994) Breathing pattern, ventilatory drive and respiratory muscle strength in patients with chronic heart failure. Eur Respir J 7:17–22.PubMedCrossRefGoogle Scholar
  10. 10.
    Evans SA, Watson L, Hawkins M, Cowley AJ, Johnston JDA, Kinnear WJM (1995) Respiratory muscle strength in chronic heart failure. Thorax 50:625–628.PubMedCrossRefGoogle Scholar
  11. 11.
    McParland C, Resch EZ, Krishnan B, Wang Y, Cujec B, Gallagher CG (1995) Inspiratory muscle weakness in chronic heart failure: role of nutrition and electrolyte status and systemic myopathy. Am J Respir Crit Care Med 151:1101–1107.PubMedGoogle Scholar
  12. 12.
    Bellemare F, Bigland Ritchie B (1984) Assessment of human diaphragm strength and activation using phrenic nerve stimulation. Respir Physiol 58:263–277.PubMedCrossRefGoogle Scholar
  13. 13.
    Supinski G, DiMarko A, Dibner-Dunlap M (1994) Alterations in diaphragm strength and fatiguability in congestive heart failure. J Appl Physiol 76:2707–2713.PubMedGoogle Scholar
  14. 14.
    Howell S, Maarek JMI, Fournier M, Sullivan K, Zhan WZ, Sieck GC (1995) Congestive heart failure: differential adaptation of the diaphragm and latissimus dorsi. J Appl Physiol 79:389–397.PubMedGoogle Scholar
  15. 15.
    Bellemare F, Grassino A (1982) Effects of pressure and timing of contraction on human diaphragm fatigue. J Appl Physiol 53:1190–1196.PubMedCrossRefGoogle Scholar
  16. 16.
    Aubier M, Trippenbach T, Roussos C (1981) Respiratory muscle fatigue during cardiogenic shock. J Appl Physiol 51:499–508.PubMedGoogle Scholar
  17. 17.
    Mancini DM, LaManca JJ, Donchez LJ, Levine S, Henson DJ (1995) Diminished respiratory muscle endurance persists after cardiac tranplantation. Am J Cardiol 75:418–421.PubMedCrossRefGoogle Scholar
  18. 18.
    Stassijns G, Lysens R, Decramer M (1996) Peripheral and respiratory muscles in chronic heart failure. Eur Respir J 9:2161–2167.PubMedCrossRefGoogle Scholar
  19. 19.
    Anger M, Lambert F, Chemla D, et al (1995) Sarcoplasmatic reticulum Ca2+ pumps in heart and diaphragm of cardiomyopathic hamster: effects of perindopril. Am J Physiol 268:1947–1953.Google Scholar
  20. 20.
    Lindsay DC, Lovegrove CA, Dunn MJ, et al (1996) Histological abnormalities of muscle from limb, thorax and diaphragm in chronic heart failure. Eur Heart J 17:1239–1250.PubMedCrossRefGoogle Scholar
  21. 21.
    Levine B, Kaiman J, Mayer L, Fillit H, Parker M (1990) Elevated circulating levels of tumor necrosis factor in severe chronic heart failure. N Engl J Med 323:236–241.PubMedCrossRefGoogle Scholar
  22. 22.
    Nishigaki K, Minatoguchi S, Seishima M, et al (1997) Plasma Fas ligand, an inducer of apoptosis, and plasma soluble Fas, an inhibitor of apoptosis, in patients with chronic congestive heart failure. J Am Coll Cardiol 29:1214–1220.PubMedCrossRefGoogle Scholar
  23. 23.
    Shindoh C, Hida W, Ohkawara Y, et al (1995) TNF-a mRNA expression in diaphragm muscle after endotoxin administration. Am J Respir Crit Care Med 152:1690–1696.PubMedGoogle Scholar
  24. 24.
    Leblanc P, Bowie DM, Summers E, Jones NL, Killian KJ (1985) Breathlessness, effort and tension. Am Rev Respir Dis 133:21–25.Google Scholar
  25. 25.
    Killian KJ, Gandevia SC, Summers E, Campbell EJM (1984) Effect of increased lung volume on perception of breathlessness, effort, and tension. J Appl Physiol 57:686–691.PubMedGoogle Scholar
  26. 26.
    Lemaire F, Teboul JL, Cinotti L, et al (1988) Acute left ventricular dysfunction during unsuccessful weaning from mechanical ventilation. Anesthesiology 69:171–179.PubMedCrossRefGoogle Scholar
  27. 27.
    Lemaire F (1993) Difficult weaning. Intensive Care Med 19:69–73.CrossRefGoogle Scholar
  28. 28.
    Richard Ch, Teboul J-L, Archanbaud F, Herbert J-L, Michaut P, Auzepy P (1994) Left ventricular function during weaning of patients with chronic obstructive pulmonary disease. Intensive Care Med 20:181–186.PubMedCrossRefGoogle Scholar
  29. 29.
    Biondi JW, Schulman DS, Matthay RA (1988) Effects of mechanical ventilation on right and left ventricular function. Clin Chest Med 9:55–74.PubMedGoogle Scholar
  30. 30.
    Robotham JL, Becker LC (1994) The cardiovascular effects of weaning: Stratifying patient populations. Intensive Care Med 20:171–172.PubMedCrossRefGoogle Scholar
  31. 31.
    Permutt S (1988) Circulatory effects of weaning from mechanical ventilation: The importance of transdiaphragmatic pressure. Anesthesiology 69:157–160.PubMedCrossRefGoogle Scholar
  32. 32.
    Takata M, Robotham JL (1992) Effects of inspiratory diaphragmatic descent on inferior vena caval venous return. J Appl Physiol 72:597–607.PubMedGoogle Scholar
  33. 33.
    Takata M, Wise RA, Robotham JL (1990) Effects of abdominal pressure on venous return. J Appl Physiol 69:1961–1972.PubMedGoogle Scholar
  34. 34.
    Fessier HE, Permutt S (1995) Interaction between the circulatory and ventilatory pumps. In: Roussos Ch. (ed) The Thorax, 2nd ed. Marcel Dekker, New York, pp 1621–1640.Google Scholar
  35. 35.
    Rasanen J, Nikki P, Heikkila J (1984) Acute myocardial infarction complicated by respiratory failure. The effects of mechanical ventilation. Chest 85:21–28.PubMedCrossRefGoogle Scholar
  36. 36.
    Hurford WE, Lynch KE, Strauss WH, Lowenstein E, Zapol WM (1991) Myocardial perfusion as assessed by thallium 201 scintigraphy during the discontinuation of mechanical ventilation in ventilator dependent patients. Anesthesiology 74:1007–1016.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • T. Vassilakopoulos
  • C. Roussos
  • S. Zakynthinos

There are no affiliations available

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