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European Journal of Heart Failure 2004 6(6):745-748; doi:10.1016/j.ejheart.2003.11.008
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© 2004 European Society of Cardiology

The effect of aspirin on the ventilatory response to exercise in chronic heart failure

Klaus K.A. Witte* and Andrew L. Clark

Department of Academic Cardiology, Castle Hill Hospital Castle Road, Cottingham Hull, HU16 5JQ, UK

* Corresponding author. Tel.: +44-1482-624073; fax: +44-1482-624071.. E-mail address: klauswitte{at}hotmail.com


  Abstract

Introduction: Patients with chronic heart failure (CHF) experience breathlessness and fatigue on exercise. One of the abnormalities seen on maximal exercise testing is an increased ventilatory response to exercise (VE/VCO2 slope). The cause of this is unknown, but is likely to be due to a combination of interacting peripheral and central factors. Recent data have demonstrated a relation between VE/VCO2 slope and prostaglandin levels in contracting muscles. The present study examined the influence of the presence of a potent non-selective prostaglandin inhibitor, aspirin, on the ventilatory response to exercise in a group of patients with CHF.

Methods: We investigated the ventilatory response to exercise of 120 consecutive patients in sinus rhythm attending a specialist heart failure clinic. We excluded those taking clopidogrel (six patients) and those on both warfarin and aspirin or taking other non-steroidal anti-inflammatory agents (five patients). The other 109 patients were grouped according to whether they were taking aspirin (n=52 (48%)) or not (n=57 (52%)). Each patient underwent echocardiography to assess left ventricular function, and exercise testing with metabolic gas exchange to derive peak oxygen consumption (pVO2) and the VE/VCO2 slope.

Results: The groups were similar in terms of age, (67 (13) vs. 66 (12) years; P=0.34) drug use, heart failure aetiology, left ventricular function (ejection fraction; 33.3 (9.4) vs. 31.8 (9.9)%; P=0.05)) and exercise tolerance (pVO2; 20.4 (5.3) vs. 19.9 (6.0); P=0.68, and VE/VCO2 slope; 35.4 (6.2) vs. 35.7 (9.3); P=0.73). There was no difference in the ventilatory response to exercise or the symptoms of breathlessness between the two groups.

Conclusions: Aspirin does not appear to affect exercise performance in CHF.

Key Words: Prostaglandins • Ventilation • Chronic heart failure

Received July 11, 2003; Revised October 1, 2003; Accepted November 19, 2003


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