Effect of Exercise on Cardiac Output and Pulmonary Arterial Pressure in Normal Persons and in Patients With Cardiovascular Disease and Pulmonary Emphysema 1

Abstract

The changes in the circulation of patients with heart disease and with emphysema have been studied many times when the patient was at bed rest. There is little information as to the changes produced when the circulatory requirements exceed the resting level. This information is probably of more importance than resting measurements as the greater part of existence is one of activity. Chronic emphysema produces changes in the heart in many patients. Congestive failure leads to water logging of the lungs. It was felt that simultaneous measurements of the cardiac output and pulmonary arterial pressure in normal persons and in those with emphysema and heart failure would aid in the understanding of the alterations of cardiac and pulmonary functions occurring in these diseases. The purpose of this paper is to present these data and to discuss their significance. METHODSIntracardiac catheterization was performed in the usual manner (1). The catheter was passed for a distance of 1 to 2 inches into the right or left main branch of the pulmonary artery. Pulmonary arterial pressures were recorded by a Hamilton manometer and mean pressures determined by planimetric integration, covering a period of at least 2 respiratory cycles. Atrial pressures were determined either in the same fashion, using a sufficiently sensitive Hamilton manometer, or by the use of a saline manometer. Systemic arterial pressures were measured in most cases from the brachial artery, using a Hamilton manometer. The point of zero reference was 5 cm. beneath the fourth left costochondral junction. Mixed venous blood samples were taken from the pulmonary artery in nearly all cases; otherwise, they were from the ventricle or atrium. Arterial samples were taken through an in-lying needle, usually in the brachial artery but occasionally in the radial or femoral arteries.

Ventilation and haemodynamics in heart disease.

“…These are shown in Table II (Riley et al, 1948;Hickam and Cargill, 1948;Dexter et al, 1951;Lewis et al, 1952;Slonim et al, 1954;Donald et al, 1955;Freedman et al, 1955;Barratt-Boyes and Wood, 1957).…”

Studies of Congenital Heart Disease

“…The only change in position between the resting and exercise periods was that of raising the feet 6 to 12 inches so as to clear the table during pedaling. With both exercise periods, the speed was regulated by a metronome at 56 revolutions per minute (R.P.M.).…”

The Effect of Khellin on Cardio-Pulmonary Function in Chronic Pulmonary Disease 12

“…The response to exercise was normal in all cases with respect to cardiac index and arteriovenous oxygen difference (13). The cardiac indices ranged from 3.4 to 5.1 L/min./M2B.S.…”