Genese der Atemeffizienzstörung unter Belastung bei Patienen mit chronischer Herzinsuffizienz: Rolle der pulmonalen Perfusion und einer veränderten kardiorespiratorischen Reflexaktivierung

降低的呼吸效率（如将通气量与二氧化碳输出量[VE/VCO 2-斜率]相关的线性回归线的斜率所测量的）是慢性心力衰竭的关键特征。它与患者的症状状态密切相关，甚至在这些患者的预后评估中超过峰值耗氧量。肺泡死腔通气，这是由于不均匀的肺血流分布，是增加的VE/VCO 2斜率在心力衰竭的主要贡献者。目前尚不清楚它是否反映了原发性肺血管病变或仅仅是运动时未能充分增加心输出量。过度换气是导致VE/VCO 2斜率增加的另一个因素，被认为是由运动过程中的异常刺激引起的，即肌肉运动反射激活。其与心输出量的关系至今尚未研究。因此，我们的目的是研究急性和慢性心输出量变化对慢性心力衰竭患者肺泡死腔通气、功反射激活和运动诱导的过度通气的影响。

Reduced ventilatory efficiency (as measured as the slope of the linear regression line relating ventilation to carbon dioxide output [VE/VCO2-slope]) is a key feature of chronic heart failure. It is closely associated with patients¿ symptom state and eclipses even peak oxygen consumption in the prognostic assessment of these patients. Alveolar dead space ventilation, which results from an uneven pulmonary blood flow distribution, is the major contributor to the increased VE/VCO2-slope in heart failure. It is unclear whether it reflects a primary pulmonary vascular pathology or simply the failure to adequately increase cardiac output during exercise. Hyperventilation another contributor to an increased VE/VCO2-slope is thought to arise from abnormal ventilatory stimuli, namely muscle-ergoreflex activation, during exercise. Its relation to cardiac output has not been investigated so far. We, therefore, aim to investigate the effects of acute and chronic changes in cardiac output on alveolar dead space ventilation, ergoreflex activation and exercise induced hyperventilation in patients with chronic heart failure.