Examination of the Relationship and Dissociation between Minimum Minute Ventilation/Carbon Dioxide Production and Minute Ventilation vs. Carbon Dioxide Production Slope

Abstract

Background: Minute ventilation/carbon dioxide production (V E/V CO2) is a variable of cardiopulmonary exercise testing (CPET), which is evaluated by arterial CO2 pressure and ventilation-perfusion mismatch via invasive methods. This study evaluated substitute non-invasively obtained variables for minimum V E/V CO2 (Min) and V E vs. V CO2 slope (Slope) and the relationship between Min and Slope. Methods and Results: This study enrolled 1,052 patients with heart disease who underwent CPET and impedance cardiography simultaneously. At first, the correlations between the end-tidal CO2 pressure (PETCO2), tidal volume/respiratory rate (TV/RR) ratio, V E and V CO2 Y-intercept (Y-int), and cardiac index (CI) and the Min and Slope were investigated. Second, the correlation between Min and Slope was investigated. PETCO2 showed the largest correlation value among the 4 variables. These 4 variables could reveal 84.2% and 81.9% of Min and Slope, respectively. Although Slope correlated with Min (R=0.868) and predicted 78.9% of Min, considering these 4 variables, Slope+Y-int was more strongly correlated with Min (R=0.940); the Slope+Y-int revealed 90.6% of the Min relationship in the multiple regression analysis. Conclusions: Over 80% of the Min and Slope values were revealed with the above-mentioned 4 variables collected non-invasively. The formula, Min∝Slope+Y-int, can reveal >90% of the Min/Slope relationships, and the Y-int may be a crucial factor to clarify the relationship between Min and Slope.