The elevated ventilatory response in HF patients seen before lactic acidosis ensues and the carbon dioxide (CO 2) generated by the lactate is trivial relative to the rate of metabolic CO 2 production (VCO 2). The relationship between VE and VCO 2 is used to evaluate ventilatory efficiency in HF, as well as in pulmonary arterial hypertension, an increase of the slope of the VE vs. VCO 2 relationship is associated with a poor prognosis –. In COPD, ventilatory limitation to exercise is defined either as a reduction of ventilatory reserve or as a lowering of inspiratory capacity. In case of severe COPD, the rise of ventilation during exercise is blunted, and consequently the slope of VE vs.
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