Pulmonary function studies were carried out during pregnancy in 8 normal women, in 8 patients with valvular (either mitral or aortic) heart disease, and in 8 patients with chronic pulmonary disease (either emphysema or sarcoidosis). In healthy pregnant women, changes in lung volumes and maximal expiratory flow rates were not significant. Diffusing capacity tended to decrease associated with unchanged pulmonary capillary blood volume. In patients with valvular heart disease, ventilation and oxygen consumption increased toward the term. The patients with mitral valve lesions showed a significant decrease in diffusing capacity with an increase in pulmonary capillary blood volume. In patients wth emphysema, characteristic changes were increasing obstructive functional abnormalities associated with an increase in pulmonary diffusing capacity and pulmonary capillary blood volume. None of these patients, however, had clinical evidence of deterioration of their disease. Patients with sarcoidosis had no appreciable alteration in pulmonary function tests.The influence of various factors, such as increased ovarian hormones, ventilation-perfusion relationships, intra-abdominal distension, and cardiac haemodynamics, are discussed in relation to the change in pulmonary diffusing capacity and pulmonary capillary blood volume. From the standpoint of pulmonary function studies we think that patients with mitral heart disease and those with pulmonary emphysema tolerate pregnancy less favourably than normal subjects and patients with sarcoidosis.The influence of pregnancy on pulmonary function has been reported by many workers. While some investigators found that pregnancy has little effect on overall respiratory function, others felt that such factors as the gradual abdominal distension, the enlarged breasts, and the inherent circulatory changes do indeed affect the respiratory physiology in the pregnant woman. In the chronically ill patient, it is even more difficult to overlook the progression of respiratory symptoms and the diminution of cardiac reserve during the second half of pregnancy and during the early post-partum period. Part of the problem becomes evident when one notes that there have been only a few reports of serial pulmonary function studies in normal pregnant women as well as in pregnant patients with cardiopulmonary disease. This paper reports the studies of pulmonary function in 8 normal women and 16 patients with various cardiopulmonary diseases during each of the three trimesters of pregnancy and 10 weeks after delivery. Special attention is focused on changes in pulmonary diffusing capacity and pulmonary capillary blood volume. METHODS OF STUDYIn eight normal women and 16 patients, pulmonary function tests were studied during the first (10th week), the second (24th week), and the third (36th week) trimesters of pregn.ancy and 10 weeks after delivery. The data obtained 10 weeks after delivery were considered as the control values. In all patients radiographs of the chest with shielded abdomen, and electrocard...
Measurements of pulmonary blood volume (PBV) and pulmonary capillary blood volume (V,) and hemodynamic studies were made in a series of 106 patients with valvular heart disease (62 with predominant mitral lesions and 44 with predominant aortic lesions). The results were compared with the data obtained from 14 "normal" patients and nine normal subjects. In 14 "normal" patients, the PBV varied from 204 to 315 m/m2 with a mean value of 269 ml/m2, while in nine "normal" patients and nine normal subjects the V, ranged from 39 to 66 mI/M2 with a mean value of 54 mI/M2. ADDITIONAL INDEXING WORDS: AngiocardiogramPhonocardiogram Indicator-dilution curves Hemodynamic studies ESTIMATES of total pulmonary blood volume (PBV) and pulmonary capillary blood volume (V,) have been reported separately in many patients with valvular heart disease.'-10 To our knowledge, there has been no report in the literature concerning the determination and comparison of these two variables in a large group of patients. The purpose of this paper is (1) to report the results of the determintaion of both PBV and V, in a series of 106 patients with valvular heart disease compared with those obtained from a group of 14 patients with normal hemodynamics and nine normal subjects and (2) to relate these two variables to cardiac output, pulmonary vascular pressures, and resistance in these patients.
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