Clinical, Functional and Pulmonary Hemodynamic Course of Patients with Chronic Obstructive Pulmonary Disease Followed-Up Over 3 Years

Weitzenblum, E; Hirth, Christian; Parini, J.; Rasaholinjanahary, J; Oudet, P

doi:10.1159/000193919

Cited by 12 publications

(6 citation statements)

References 7 publications

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“…The correlation between FEV1 and Ppa is controversial; in one study, no correlation was found [23], whilst another long-term study reported a weak inverse correlation [16]. In the present study, in accordance with these results, a significant inverse correlation was found between Pa,O 2 and Ppa, but no correlation between FEV1 and Ppa.…”

Section: Discussionsupporting

confidence: 84%

Pulmonary haemodynamics after single-lung transplantation for end-stage pulmonary parenchymal disease

Bjørtuft

Simonsen²,

Geiran³

et al. 1996

Eur Respir J

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P Pu ul lm mo on na ar ry y h ha ae em mo od dy yn na am mi ic cs s a af ft te er r s si in ng gl le e--l lu un ng g t tr ra an ns sp pl la an nt ta at ti io on n f fo or r e en nd d--s st ta ag ge e p pu ul lm mo on na ar ry y p pa ar re en nc ch hy ym ma al l d di is se ea as se e ABSTRACT: In a prospective study, we investigated the effect of single-lung transplantation (SLT) on pulmonary haemodynamics and the relationship between pulmonary hypertension (PH) and the fraction of perfusion to the transplant in patients with end-stage pulmonary parenchymal disease.Twenty four SLT recipients were included in the study, 19 with chronic obstructive pulmonary disease (COPD), two with sarcoidosis and three with fibrosing alveolitis. Spirometry, determination of arterial blood gas values, perfusion scintigraphy and right heart catheterization were performed before and 1, 6, 12 and 24 months after transplantation. Patients with a mean pulmonary artery pressure (Ppa) ≥20 mmHg before transplantation were defined as having PH (PH group, 15 patients) and the remainder (9 patients) constituted the non-PH group.In the PH group, Ppa and pulmonary vascular resistance (PVR) were significantly decreased after transplantation: 28±2 to 18±1 mmHg and 288 to 161±11 dyne·s -1 ·cm -5 , respectively (mean±SEM). In the non-PH group, the haemodynamic parameters were unchanged after transplantation. Over the 2 year follow-up period, no significant change was found in Ppa and PVR, nor any difference between the PH and non-PH group. There was no significant difference between the two groups in terms of pulmonary perfusion to the graft.In conclusion, patients with pulmonary hypertension obtain pulmonary haemodynamics within the normal range after single-lung transplantation. Presence or absence of pulmonary hypertension before transplantation does not influence perfusion to the graft. These findings persist up to 2 yrs, despite the coexistence of an "end-stage" native lung and a lung transplant.

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Section: Discussionsupporting

confidence: 84%

Pulmonary haemodynamics after single-lung transplantation for end-stage pulmonary parenchymal disease

Bjørtuft

Simonsen²,

Geiran³

et al. 1996

Eur Respir J

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“…Pulmonary hypertension is a well-known complication of severe lung diseases such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis (1)(2)(3)(4)(5)(6). Pulmonary hypertension secondary to chronic lung diseases is usually moderate, rarely exceeding 35 to 40 mm Hg, and is related to alterations in blood gases, abnormal pulmonary mechanics, and relatively subtle vascular remodeling (5).…”

mentioning

confidence: 99%

“…The present study was therefore designed to extend this observation. Accordingly, the objectives of this study were as follows: ( 1 ) to evaluate the pulmonary hemodynamics in consecutive patients with pulmonary histiocytosis X and other chronic lung diseases referred to our center for lung transplantation, and ( 2 ) to correlate pulmonary hemodynamics with respiratory function tests and pulmonary vessel histopathology.…”

mentioning

confidence: 99%

Severe Pulmonary Hypertension in Histiocytosis X

Fartoukh

Humbert²,

Capron³

et al. 2000

Am J Respir Crit Care Med

232

166

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Diminished exercise capacity in advanced pulmonary histiocytosis X does not appear to be related to ventilatory limitation but may be related to pulmonary vascular dysfunction. Pulmonary hemodynamics and respiratory function were studied in 21 consecutive patients with advanced pulmonary histiocytosis X, and compared with parameters of patients with other severe chronic lung diseases (29 patients with chronic obstructive pulmonary disease and 14 patients with idiopathic pulmonary fibrosis). All patients with pulmonary histiocytosis X displayed severe pulmonary hypertension: mean pulmonary arterial pressure, 59 +/- 4 mm Hg; cardiac index, 2.6 +/- 0.8 L/min/m(2); and total vascular pulmonary resistance, 25 +/- 3 IU/m(2) (p < 0.05, as compared with patients with other chronic lung diseases). Pa(O(2)) was similar in the three groups, whereas FEV(1) was lower in patients with other chronic lung diseases (p < 0.05). In contrast to other chronic lung diseases, the degree of pulmonary hypertension was not related to variables of pulmonary function in pulmonary histiocytosis X. Histopathology was available for 12 patients with pulmonary histiocytosis X and revealed proliferative vasculopathy involving muscular arteries and veins, with prominent venular involvement. Two consecutive lung samples (taken before and after the occurrence of pulmonary hypertension) were available for six patients with pulmonary histiocytosis X, and showed that pulmonary vasculopathy worsened, whereas parenchymal and bronchiolar lesions remained relatively unchanged. These results indicate that pulmonary hypertension in pulmonary histiocytosis X might be related to an intrinsic pulmonary vascular disease, in which the pulmonary circulation is involved independent of small airway and lung parenchyma injury.

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“…Thus, the 2-yr mortality in our R is considerably lower than the lowest mortality reported for patients not receiving LTD0 2 . It is also lower than the reported mortality for patients receiving LTD0 2 , even in those who had the best prognostic indicators in different studies (6,10,11). On the other hand, the mortality in our NR is no better than in patients not treated with LTD0 2 (7,20,(22)(23)(24).…”

Section: Discussionmentioning

confidence: 72%

“…However, a number of patients show no improvement with oxygen therapy. Identification of these patients would spare the expense, inconvenience, and hazards (8,9) of long-term oxygen therapy, and it also might turn the attention of the physician to potentially more effective measures, such as the control of heart failure and infection (10), vasodilators (11), dextran infusion in patients with polycythemia (12), and a rehabilitation program (13). The importance of predicting a good response to oxygen therapy has been widely acknowledged (13,14).…”

Section: Introductionmentioning

confidence: 99%

Early Effects of Oxygen Administration and Prognosis in Chronic Obstuctive Pulmonary Disease and Cor Pulmonale^1–³

Kumar¹,

Mead²,

Dunsky³

1983

Am Rev Respir Dis

125

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The purpose of this study was to develop criteria for predicting survival and clinical improvement with long-term domiciliary home oxygen therapy (LTDO2) in patients with both chronic obstructive pulmonary disease (COPD) and cor pulmonale (CP). Twenty-eight such patients were divided into 2 groups, responders (R) and nonresponders (NR), on the basis of the fall in their mean pulmonary artery pressure (delta PAP) while breathing 28% O2 for 24 h. The R(n = 17) and NR (n = 11) had delta PAP greater than and lesser than 5 mmHg, respectively. Eighty-eight percent of the R, but only 22% of the NR, were alive at the end of 2 yr of LTDO2. Eighty-five percent of R, but only 11% of NR, achieved an end-exercise maximal oxygen consumption (max VO2) greater than 6.5 ml min-1 kg-1. Left ventricular ejection fraction improved while breathing O2 for 48 h in the R only. The NR and R were similar in all other respects. We conclude that delta PAP greater than 5 mmHg and/or max VO2 6.5 ml min-1 kg-1 or greater predict 2-yr survival with LTDO2 in patients with COPD and CP, and it can be useful in planning their management.

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Clinical, Functional and Pulmonary Hemodynamic Course of Patients with Chronic Obstructive Pulmonary Disease Followed-Up Over 3 Years

Cited by 12 publications

References 7 publications

Pulmonary haemodynamics after single-lung transplantation for end-stage pulmonary parenchymal disease

Pulmonary haemodynamics after single-lung transplantation for end-stage pulmonary parenchymal disease

Severe Pulmonary Hypertension in Histiocytosis X

Early Effects of Oxygen Administration and Prognosis in Chronic Obstuctive Pulmonary Disease and Cor Pulmonale^1–³

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Clinical, Functional and Pulmonary Hemodynamic Course of Patients with Chronic Obstructive Pulmonary Disease Followed-Up Over 3 Years

Cited by 12 publications

References 7 publications

Pulmonary haemodynamics after single-lung transplantation for end-stage pulmonary parenchymal disease

Pulmonary haemodynamics after single-lung transplantation for end-stage pulmonary parenchymal disease

Severe Pulmonary Hypertension in Histiocytosis X

Early Effects of Oxygen Administration and Prognosis in Chronic Obstuctive Pulmonary Disease and Cor Pulmonale1–3

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Product

Resources

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Early Effects of Oxygen Administration and Prognosis in Chronic Obstuctive Pulmonary Disease and Cor Pulmonale^1–³