NONINVASIVE ASSESSMENT OF CARDIAC-FUNCTION DURING EXERCISE IN PATIENTS WITH CHF OR COPD - MEASUREMENT OF AORTIC BLOODFLOW INDEXES BY CONTINUOUS-WAVE DOPPLER

OBJECTIVE: To test whether continuous-wave Doppler measurements of aor tic bloodflow indices would reliably distinguish patients with congest ive heart failure (CHF) from those with chronic obstructive pulmonary disease (COPD) and a similar degree of exertional dyspnea. DESIGN: Par allel group comparison. SETTING: University teaching hospital. PARTICI PANTS: Eighteen out-patients with clinically distinct syndromes of CHF or COPD but of similar age and functional limitation. INTERVENTION: P articipants were observed during graded treadmill exercise. The follow ing indices were obtained: heart rate, systolic blood pressure (SBP), earlobe oxygen saturation, and continuous-wave Doppler measurements of aortic bloodflow from the suprasternal notch. MAIN RESULTS: Exercise duration (mean+/-SE): COPD 14.2+/-1.2 mins, CHF 14.0+/-1.2 mins, not s ignificant. Maximum results during exercise: heart rate, CHF 143+/-7 b eats/min, COPD 149+/-5 beats/min, not significant; peak velocity, CHF 0.60+/-0.04 m/s, COPD 0.92+/-0.07 m/s, P<0.005; peak acceleration, CHF 17+/-1 ms(2), COPD 37+/-3 m/s(2), P<0.001; SBP: CHF 152+/-8 mmHg, COP D 207+/-5 mmHg, P<0.001; minimum oxygen saturation: CHF 92+/-1%, COPD 88+/-2%, not significant.CONCLUSIONS: Aortic bloodflow indices can be measured COPD and, in CHF, these indices are significantly reduced com pared with individuals with COPD measured at similar levels of exercis e. These data suggest that measurement of aortic bloodflow indices may have a role as an adjunct to routine tests in the diagnosis of patien ts with dyspnea. Further studies are indicated in patients with clinic al features of both COPD and CHF in whom the etiology of dyspnea is un certain.