Chemoreceptor hyperactivity in heart failure: is lactate the culprit?

<p>we propose that in patients with HF, the blunted cardiac output during exercise results in inadequate oxygen delivery to working muscle, and earlier anaerobic metabolism which increase both lactate production and H+ and both are stimulus that augment the ventilatory drive and induce an early reduction of PaCO2 tensions.</p> <p>The link between lactate and hyperventilation is further supported by the demonstration that a reduction of arterial lactate concentration throughout exercise is associated with a reduction of ventilatory response to exercise in patients with HF after 2 months of exercise training.10 Also, reduction of blood lactate concentrations by dichloroacetate administration is associated with an improvement of myocardial function in patients with HF.</p> <p>We recognize that the documentation of the correlation between blood lactate concentration and VE/VCO2 slope during exercise in HF does not prove a cause-effect relationship. Accordingly, the present report should be considered only as hypothesis generating but this fascinating hypothesis has a strong physiological background but needs to be confirmed by dedicated studies.</p> <p></p>