Onset of Dyspnea on Exertion in Elderly and Young Patients with Congestive Heart Failure.

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  • Ueshima Kenji
    The Second Departmentof Internal Medicine, Iwate Medical University Morioka
  • Kobayashi Noboru
    The Second Departmentof Internal Medicine, Iwate Medical University Morioka
  • Hashimoto Koya
    The Second Departmentof Internal Medicine, Iwate Medical University Morioka
  • Nakai Kenji
    The Second Departmentof Internal Medicine, Iwate Medical University Morioka
  • Hiramori Katsuhiko
    The Second Departmentof Internal Medicine, Iwate Medical University Morioka

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Other Title
  • 労作時呼吸困難感の出現時期に及ぼす加齢の影響　高齢および若年の慢性心不全患者での検討
  • ロウサジ コキュウ コンナンカン ノ シュツゲン ジキ ニ オヨボス カレイ
  • 高齢および若年の慢性心不全患者での検討

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We previously reported that dyspnea on exertion in patients with congestive heart failure was not associated with pulmonary function ar rest, but was associated with the appearance of the anaerobic threshold and with the respiratory compensation point during exercise. Here we described a study of the influence of aging on the onset of dyspnea on exertion in elderly and in young patients with congestive heart failure. A total of 53 patients were studied: 35 were less than 65-year-old (average age, 47-year-old; 19 men and 16 women) and 18 were more than 65-year-old (average age, 70-year-old; 13 men and 5 women). All patients underwent maximal graded exercise testing on a bicycle ergometer. The workload increased according to a ramp protocol, and perceived exertion was evaluated with the Borg scale. The anaerobic threshold, the respiratory compensation point, and the peak VO2 were recorded. Values of 13 (somewhat hard) and 17 (very hard) on the Borg scale were considered to mark the start of dyspnea on exertion and an increase in dyspnea on exertion respectively. In the young patients, dyspnea on exertion began at about the time that the anaeerobic threshold was reached, and it increased at about the time that the respiratory compensation point was reached. In contrast, elderly patients dyspnea on exertion began 70 seconds after the anaerobic threshold was reached, and it increased 30 seconds after the respiratory compensation point was reached. The VO2 at the start of dyspnea on exertion and the VO2 at the anaerobic threshold correlated more closely in the young patients than in the old patients. The same was true of the VO2 at the time that dyspnea on exertion increased and the VO2 at the respiratory compensation point. These findings suggest that elderly patients with congestive heart failure are less sensitive to the stimuli that cause dyspnea than are young patients.

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