Prognostic role of results of dynamic capnography in integral assessment of parameters of respiratory system in 6-minute walk test in patients with chronic heart failure

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Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF).

Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.9±4.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.6±3.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months).

Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р<0.05). The distance walked by the patients with CHF in 6 minutes was 488.23±90.84 m, which was significantly less than in the control group (815.60±53.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.8±3.0% and 48.0±5.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.1±5.0% in the group of CHF and 40.0±5.0% in the control group, р=0.014), palpitation (29.0±4.6% and 20.0±4.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р<0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.3±1.0% of cases (the difference with the control group with р=0.046), the trend of heart rate – in 18.8±0.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р<0.0001.

Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.

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About the authors

Kira A. Ageeva

Ryazan State Medical University

ORCID iD: 0000-0001-8537-7437
SPIN-code: 8756-3153
ResearcherId: M-9092-2016

Russian Federation, Ryazan

Assistant of the Department of Infectious Diseases

Evgenii V. Filippov

Ryazan State Medical University

Author for correspondence.
ORCID iD: 0000-0002-7688-7176
SPIN-code: 2809-2781
ResearcherId: O-1490-2016

Russian Federation, Ryazan

MD, PhD, Associate Professor, Head of the Department of Outpatient Therapy and Preventive Medicine


  1. Federal'naya sluzhba gosudarstvennoj statistiki. Available at: Accessed: 2020 May 20.
  2. Mareev VYu, Fomin IV, Ageev FT, et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia. 2018; 58(6S):8-158. doi: 10.18087/cardio.2475
  3. Ponikowski P, Voors AA, Anker SD, et al. Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2016;37(27):2129-200. doi:10.1093/ eurheartj/ehw128
  4. Obshchiye voprosy metodiki issledovaniya i kriterii otsenki pokazateley dykhaniya. In: Shik LL, Kanayev NN, editors. Rukovodstvo po klinicheskoy fiziologii dykhaniya. Leningrad: Meditsina; 1980.
  5. Tetenev FF. Osobennosti mekhaniki dykhaniya pri razlichnykh formakh patologii bronkholëgochnoy sistemy. Obosnovaniye gipotezy o mekhanicheskoy aktivnosti lëgkikh [dissertation]. Moscow; 1976.
  6. Abrosimov VN, editor. Odyshka i assotsiirovan-nyye sindromy. Ryazan: RyazGMU; 2018. Issue 6.
  7. Abrosimov VN, Alekseyeva EA, Ponomareva IB, et al. Primeneniye metodov klinicheskogo shkaliro-vaniya i voprosnikov v pul’monologii. Ryazan’: RIO RyazGMU; 2011.
  8. Byalovsky YuYu. Reciprocal reactions to different amounts of increased breathihg resistance. I.P. Pavlov Russian Medical Biological Herald. 2016; 24 (1):19-24.
  9. Abrosimov VN, Peregudova NN, Kosyakov AV. Evaluation of functional parameters of respiratory system in patients with chronic obstructive pulmonary disease in 6-minute walking test. Nauka Molodykh (Eruditio Juvenium). 2019;7(3):323-31. doi: 10.23888/HMJ201973323-331
  10. Nizov AA, Ermachkova AN, Abrosimov VN, et al. Management of patients with copd: role of evaluation of disease in real clinical practice (literature review). Nauka Molodykh (Eruditio Juvenium). 2018;6(3):429-38. doi: 10.23888/HMJ201863429-438
  11. Graham BL, Steenbruggen I, Miller MR, et al. Stan-dardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. American Journal of Respiratory and Critical Care Medicine. 2019;200(8): e70-e88. doi: 10.1164/rccm.201908-1590st
  12. Metodicheskiye rekomendatsii po ispol’zovaniyu metoda spirometrii. Available at: obrazovatelnye-resursy/federalnye-klinicheskie-rekomendatsii. Accessed: 2020 May 20.
  13. Vorob’yeva ZV. Funktsiya vneshnego dykhaniya pri khronicheskoy obstruktivnoy bolezni legkikh v stadii 0 (nol’). Funktsional’naya Diagnostika. 2005; (2):29-32.
  14. Agostoni P, Corrà U, Emdin M. Periodic Breathing during Incremental Exercise. Annals of the American Thoracic Society. 2017;14(S1):S116-22. doi:10.1513/ AnnalsATS.201701-003FR
  15. Baruch V, Amin A, Christle JW, et al. A method for determining exercise oscillatory ventilation in Heart Failure: prognostic value and practical implications. International Journal of Cardiology. 2017; 249:287-91. doi: 10.1016/j.ijcard.2017.09.028

Supplementary files

Supplementary Files Action
Fig. 1. Examples of CO2 trends in a patient with II FC CHF (A) and III FC CHF (B) during 6MWT

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Fig. 2. Survival (A) and risk of lethal outcome (B) in patients with CHF and signs of periodical breathing

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