Skip to main content

ORIGINAL RESEARCH article

Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1380562

Improved exercise ventilatory efficiency with nasal compared to oral breathing in cardiac patients

Provisionally accepted
Prisca Eser Prisca Eser 1,2*Pietro Calamai Pietro Calamai 3Anja Kalberer Anja Kalberer 3Laura Stuetz Laura Stuetz 3Sarina Huber Sarina Huber 3Dominic Kaesermann Dominic Kaesermann 3Sabina Guler Sabina Guler 4Matthias Wilhelm Matthias Wilhelm 3
  • 1 Rehabilitation & Sports Medicine, University Hospital of Bern, Bern, Bern, Switzerland
  • 2 University of Bern, Bern, Bern, Switzerland
  • 3 University Hospital of Bern, Bern, Bern, Switzerland
  • 4 Department of Pulmonary Medicine, University Hospital of Bern, Bern, Bern, Switzerland

The final, formatted version of the article will be published soon.

    To assess whether nasal breathing improves exercise ventilatory efficiency in patients with heart failure (HF) or chronic coronary syndromes (CCS).Exercise inefficient ventilation predicts disease progression and mortality in patients with cardiovascular diseases. In healthy people, improved ventilatory efficiency with nasal compared to oral breathing was found.Four study groups were recruited: Patients with HF, patients with CCS, old (age≥45 years) and young (age 20 to 40 years) healthy control subjects. After a 3-min warm-up, measurements of 5 min with once nasal and once oral breathing were performed in randomized order at 50% peak power on cycle ergometer. Ventilation and gas exchange parameters measured with spiroergometry were analysed by Wilcoxon paired-sample tests and linear mixed models adjusted for sex, height, weight and test order.Groups comprised 15 HF, CCS, and young control and 12 old control. Ventilation/carbon dioxide production (V ̇E/V ̇CO2), ventilation (V ̇E), breathing frequency (fR), and end-tidal oxygen partial pressure (PETO2) were significantly lower and tidal volume and end-tidal carbon dioxide partial pressure (PETCO2) significantly higher during nasal compared to oral breathing in all groups, with large effect sizes for most parameters. For patients with HF, median V ̇E/V ̇CO2 was 35% lower, with nasal compared to oral breathingfR 26% lower, and PETCO2 10% higher with nasal compared to oral breathing, respectively. in 14 of 15 patients with HF and 13 of 15 patients with CCS. Exercise oscillatory ventilation (EOV) was present in 6 patients and markedly reduced with nasal breathing.Nasal breathing during submaximal exercise significantly improved ventilatory efficiency and abnormal breathing patterns (rapid shallow breathing and EOV) in 80% of our patients with HF and CCS.

    Keywords: V ̇E/V ̇CO2 ratio, Rapid shallow breathing index, Exercise oscillatory ventilation, Heart Failure, Nasal breathing

    Received: 01 Feb 2024; Accepted: 02 Jul 2024.

    Copyright: © 2024 Eser, Calamai, Kalberer, Stuetz, Huber, Kaesermann, Guler and Wilhelm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Prisca Eser, Rehabilitation & Sports Medicine, University Hospital of Bern, Bern, 3010, Bern, Switzerland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.