Cardiopulmonary exercise testing for identification of patients with hyperventilation syndrome

BRAT, Kristián, Nela ŠŤASTNÁ, Zdeněk MERTA, Lyle J. OLSON, Bruce D. JOHNSON and Ivan ČUNDRLE. Cardiopulmonary exercise testing for identification of patients with hyperventilation syndrome. Plos one. San Francisco: Public Library of Science, 2019, vol. 14, No 4, p. 1-13. ISSN 1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0215997.

Basic information

Original name

Cardiopulmonary exercise testing for identification of patients with hyperventilation syndrome

Authors

BRAT, Kristián (703 Slovakia, belonging to the institution), Nela ŠŤASTNÁ (203 Czech Republic, belonging to the institution), Zdeněk MERTA (203 Czech Republic, belonging to the institution), Lyle J. OLSON (840 United States of America), Bruce D. JOHNSON (840 United States of America) and Ivan ČUNDRLE (203 Czech Republic, guarantor, belonging to the institution)

Edition

Plos one, San Francisco, Public Library of Science, 2019, 1932-6203

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Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.740

RIV identification code

RIV/00216224:14110/19:00109665

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1371/journal.pone.0215997

UT WoS

000465223900061

Keywords in English

hyperventilation syndrome

Tags

14110122, 14110215, rivok

Tags

International impact, Reviewed

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Abstract

V originále

Introduction Measurement of ventilatory efficiency, defined as minute ventilation per unit carbon dioxide production (V-E/VCO2), by cardiopulmonary exercise testing (CPET) has been proposed as a screen for hyperventilation syndrome (HVS). However, increased V-E/VCO2 may be associated with other disorders which need to be distinguished from HVS. A more specific marker of HVS by CPET would be clinically useful. We hypothesized ventilatory control during exercise is abnormal in patients with HVS. Methods Patients who underwent CPET from years 2015 through 2017 were retrospectively identified and formed the study group. HVS was defined as dyspnea with respiratory alkalosis (pH >7.45) at peak exercise with absence of acute or chronic respiratory, heart or psychiatric disease. Healthy patients were selected as controls. For comparison the Student t-test or Mann-Whitney U test were used. Data are summarized as mean +/- SD or median (IQR); p<0.05 was considered significant. Results Twenty-nine patients with HVS were identified and 29 control subjects were selected. At rest, end-tidal carbon dioxide (PETCO2) was 27 mmHg (25-30) for HVS patients vs. 30 mmHg (28-32); in controls (p = 0.05). At peak exercise PETCO2 was also significantly lower (27 +/- 4 mmHg vs. 35 +/- 4 mmHg; p< 0.01) and V-E/VCO2 higher ((38 (35-43) vs. 31 (27-34); p< 0.01)) in patients with HVS. In contrast to controls, there were minimal changes of PETCO2 (0.50 +/- 5.26 mmHg vs. 6.2 +/- 4.6 mmHg; p< 0.01) and V-E/VCO2 ((0.17 (-4.24-6.02) vs. -6.6 (-11.4-(-2.8)); p< 0.01)) during exercise in patients with HVS. The absence of V-E/VCO2 and PETCO2 change during exercise was specific for HVS (83% and 93%, respectively). Conclusion Absence of V-E/VCO2 and PETCO2 change during exercise may identify patients with HVS.