Difference in prevalence of exertional oscillatory ventilation between healthy subjects and patients with cardiovascular disease

Exercise oscillatory ventilation (EOV) is an ominous sign in heart failure due to reduced left ventricular ejection fraction (HFrEF) whatever it is represented. But EOV is detected also in normal healthy individuals and in other cardiovascular disease (CVD) patients, however, its prevalence in these is not completed clear. The aim was to describe the occurrence of EOV in healthy subjects and the overall population all CVD patients who performing symptom limited cardiopulmonary exercise testing (CPET). Healthy subjects were divided in athletes and normal subjects, while, CVD patients were subdivided into: i) t hose with preserved left ventricular ejection fraction (LVEF); ii) those with mild to moderate impairment of LVEF (41-49%); iii) those with severe impairment of LVEF (≤40%); iv) HFrEF or with preserved LVEF (HFpEF); and iv) patients after heart transplantation (HXT). EOV was observed only in CVD patients and in those with depressed LVEF; the prevalence of EOV was observed 1.9% (3/55) those with mild to moderate impairment of LVEF (41-49%), 3.4% (56/1613) those with severe impairment of LVEF (≤40%), and 7.3% (214/2903) in HFrEF); no EOV was observed in CVD with preserved LVEF. Kremser’s EOV was observed in patients, and, particularly, in those with systolic function impairment. Moreover, as EOV impacts prognosis in HFrEF, its occurrence can modify prognostic-decision models. Even though, EOV prevalence was derived from largest single center population, more studies are needed to tackle the EOV prevalence in different CVD conditions and in normal subjects.