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Preliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea.

ABSTRACT: The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF).This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I-III) were recruited. The baseline characteristics included duration of disease, Brunnstrom stage, spirometry, resting heart rate, resting oxyhemoglobin saturation (SpO2), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Borg scale, fatigue scale, and Barthel index.A total of 47 stroke patients (24 males, 23 females, mean age 65.9?±?11.5 years) were included. The average Brunnstrom stages of affected limbs were 3.6?±?1.3 over the proximal parts and 3.5?±?1.4 over the distal parts of upper limbs, and 3.9?±?0.9 over lower limbs. The average forced vital capacity (FVC) was 2.0?±?0.8?L, with a predicted FVC% of 67.9?±?18.8%, forced expiratory volume in the first second (FEV1) of 1.6?±?0.7?L, predicted FEV1% of 70.6?±?20.1%, FEV1/FVC of 84.2?±?10.5%, and maximum mid-expiratory flow of 65.4?±?29.5%. The average MIP and MEP were -52.9?±?33.3?cmH2O and 60.8?±?29.0?cmH2O, respectively. The Borg scale was 1.5?±?0.8. MIP was negatively associated with the average Brunnstrom stage of the proximal (r?=?-0.318, P?

SUBMITTER: Liaw MY

PROVIDER: S-EPMC5059080 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Preliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea.

Liaw Mei-Yun MY Wang Lin-Yi LY Pong Ya-Ping YP Tsai Yu-Chin YC Huang Yu-Chi YC Yang Tsung-Hsun TH Lin Meng-Chih MC

Medicine 20161001 40

The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF).This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I-III) were recruited. The baseline characteristics included duration ...[more]

PMID: 27749577

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Project description:Heart Failure with preserved Ejection Fraction (HFpEF) is a major global health problem but there are no effective therapies. The aim of this study was to assess the effects of histone deacetylase (HDAC) inhibition on cardiopulmonary structure, function, and metabolism in a large mammalian (feline) pressure overload model with HFpEF features. Male domestic short hair cats (n=26, aged 2mo), underwent either a sham procedure (n=5) or aortic constriction (n=21) using a pre-shaped band, resulting in slow-progressive pressure overload during subsequent growth. Two-months post-banding, banded cats were treated daily with either 10mg/kg suberoylanilide hydroxamic acid (b+SAHA) (n=8), an FDA approved pan-HDAC inhibitor, or vehicle (b+veh) (n=8) for 2 months. Echocardiography at 4-months post-banding revealed that b+SAHA animals had a significant reduction in left ventricular hypertrophy (LVH) and LA size vs b+veh animals. Invasively measured left ventricular end-diastolic pressure (LVEDP) and mean pulmonary arterial pressure (mPAP) were significantly elevated in b+veh and significantly reduced by b+SAHA. SAHA speeded ex-vivo myofibril relaxation independent of LVH and this effect correlated with in-vivo indices of LV relaxation. Furthermore, SAHA preserved lung structure, improved lung compliance and oxygenation, reflected by a decrease in alveolar-capillary wall thickness, alveolar-arterial oxygen gradient (A-aDO2), and intrapulmonary shunt. SAHA also reduced perivascular fluid cuffs around extra-alveolar vessels, suggesting attenuated alveolar-capillary stress failure. Acetylation proteomics revealed that SAHA altered protein acetylation in cat hearts, including histones, many mitochondrial metabolic enzymes involved in electron transport chain, TCA cycle, malate aspartate shuttle and beta oxidation, as well as cytoskeletal proteins important for muscle function. These results suggest that acetylation defects in hypertrophic stress states can be reversed by HDAC inhibitors and may be useful to improve cardiac structure and function in HFpEF patients.

Dataset Information

Preliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea.

Publications

Preliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea.

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