Inspiratory Capacity and Dynamic Hyperinflation During Exercise in Patients With Cardiovascular Disease: A SYSTEMATIC REVIEW

Seven studies including 231 patients with CVD (mean age 31-66 yr, predominantly male) used cardiopulmonary exercise testing to evaluate exercise-induced DH or EFL with varying definitions. Study quality was mixed. Patients with myocardial infarction showed EFL at moderate exercise, while patients with stable coronary artery disease exhibited EFL only at high intensities. Up to 50% of patients with pulmonary arterial hypertension have DH during peak exercise (P < .05). In patients with heart failure, 25% experienced DH, while others maintained stable breathing. Patients who are post-Fontan displayed pulmonary inefficiencies without DH. Methodological variability precludes definitive conclusions on DH prevalence in patients with CVD. However, reduced IC during exercise, DH, and EFL occur in a substantial proportion of patients, indicating a lower EFL threshold and earlier ventilatory constraints. Further research into heart-lung integration during exercise is crucial for developing personalized treatments and improving clinical management in those patients.