Heart failure and airway obstruction

Petermann, W; Barth, Jürgen; Entzian, P.

doi:10.1016/0167-5273(87)90132-x

Cited by 60 publications

(34 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, it is known that pulmonary vascular congestion can affect the reactivity of airways in heart failure patients . We did not find that fluid overload—indicated by either low residual diuresis and large ultrafiltrations during dialysis were associated with airflow limitation indicative of COPD (Table ).…”

Section: Discussionmentioning

confidence: 63%

Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

Plesner

Warming

Nielsen

et al. 2015

Hemodialysis International

View full text Add to dashboard Cite

The objectives of this study were to assess the prevalence of chronic obstructive pulmonary disease (COPD) in hemodialysis patients with spirometry and to examine the effects of fluid removal by hemodialysis on lung volumes. Patients ≥18 years at two Danish hemodialysis centers were included. Forced expiratory volume in one second (FEV1 ), forced vital capacity (FVC), and FEV1 /FVC ratio were measured with spirometry before and after hemodialysis. The diagnosis of COPD was based on both the GOLD criteria and the lower limit of normal criteria. There were 372 patients in treatment at the two centers, 255 patients (69%) completed spirometry before dialysis and 242 of these (65%) repeated the test after. In the initial test, 117 subjects (46%) had airflow limitation indicative of COPD with GOLD criteria and 103 subjects (40.4%) with lower limit of normal criteria; COPD was previously diagnosed in 24 patients (9%). Mean FVC and FEV1 decreased mildly after dialysis (FVC: 2.84 to 2.79 L, P < 0.01. FEV1 : 1.97 to 1.93 L, P < 0.01) Hemodialysis did not affect the FEV1 /FVC ratio or number of subjects with airflow limitation indicative of COPD (113 vs. 120, P = 0.324; n = 242). COPD is a frequent and underdiagnosed comorbidity in patients on chronic hemodialysis. Spirometry should be considered in all patients on dialysis in order to address dyspnea adequately. Hemodialysis induced a small fall in mean FEV1 and FVC, which was more pronounced in patients with little or no fluid removal, but the FEV1 /FVC ratio and the number of subjects with airflow limitation indicative of COPD were not affected by dialysis.

show abstract

Section: Discussionmentioning

confidence: 63%

Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

Plesner

Warming

Nielsen

et al. 2015

Hemodialysis International

View full text Add to dashboard Cite

show abstract

“…Increases in airway resistance both in human and animal studies are reported to be more prominent in small rather than large airways [2][3][4][5][6]. The mechanism for this effect remains an issue of debate [7].…”

mentioning

confidence: 99%

“…Pulmonary congestion, resulting from either poor left ventricular function [1][2][3] or rapid volume loading [4], will impair pulmonary function. Increases in airway resistance both in human and animal studies are reported to be more prominent in small rather than large airways [2][3][4][5][6].…”

mentioning

confidence: 99%

The role of submucosal oedema in increased peripheral airway resistance by intravenous volume loading in dogs

Freed

1994

Eur Respir J

View full text Add to dashboard Cite

Pulmonary congestion leads to an increase in airway resistance. It is still unknown whether this is due to vascular engorgement or to submucosal oedema. The present study was designed to determine the relative contribution of these two potential mechanisms. We examined the effect of intravenous volume loading on canine peripheral airway resistance (Rp). Bronchoscopes were wedged in contralateral sublobar segments and used to record Rp during rapid infusion of normal saline. Volume loading with normal saline increased pulmonary capillary wedge pressure (PCWP) and Rp. Unlike normal saline, dextran 70 did not increase Rp when infused at a rate that produced similar changes in PCWP. During infusion of normal saline, delta Rp was significantly enhanced in lung segments previously challenged with dry air when compared to contralateral control lungs, unexposed to dry air, and the use of dextran 70 significantly reduced this effect. Vasoconstriction with phenylephrine significantly decreased baseline Rp, but did not completely reverse the effect of fluid infusion. In addition, in lung segments exposed to dry air, delta Rp was significantly greater after volume loading and treatment with phenylephrine when compared to contralateral control lung. Finally, muscarinic receptor blockade was ineffective in preventing Rp from increasing during infusion of normal saline. Our results suggest that volume loading-induced increases in Rp are not caused by either vascular engorgement or the stimulation of muscarinic receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

show abstract

“…tained during the period observed, indicating that, in that group, most patients had mild obstructive ventilatory disorder. Petermann et al 4 also reported a mild obstructive disorder in 60 patients with decompensated congestive heart failure, with no significant impairment in gas exchanges. Other authors reported a significant bronchodilating response to the use of salbutamol and ipratropium bromide, indicating that chronic congestive heart failure may result in a mild obstructive ventilatory disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the knowledge about the pulmonary alterations associated with chronic congestive heart failure has been the object of extensive reviews [2][3][4] , but a report on the pulmonary manifestations attributed exclusively to diastolic heart failure is still lacking.…”

Section: Discussionmentioning

confidence: 99%

Insuficiência respiratória persistente secundária a insuficiência cardíaca diastólica

Neto¹,

Benchimol²,

Lima³

2004

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

This study assessed two 85-year-old The incidence and prevalence of congestive heart failure have progressively increased in industrialized countries, because of their population aging and the longer survival of individuals with coronary artery disease 1 . Consequently, an increasing number of clinical findings, as of yet unknown, may be present in elderly patients with congestive heart failure. This study assesses 2 elderly patients with diastolic heart failure, who developed severe and persistent respiratory impairment, which led to death. The possibility that the respiratory findings could be attributed to primary pulmonary disease was ruled out based on clinical data and complementary tests. These respiratory findings, characterized by the presence of severe obstructive ventilatory disorder and important and persistent gas exchange alterations, also differ from the respiratory manifestations already described in chronic congestive heart failure. Case reportCase 1 -The patient was an 85-year-old man, who sought medical care at the Hospital São Vicente de Paulo in August 1998 for the first time, when, reporting worsening of the dyspnea initiated months before, he was brought to the emergency unit and immediately referred to the ICU. The patient denied antecedents of smoking and of respiratory disease, but reported exposure to vegetal coal in an open environment during work.On physical examination, the patient was restless, objectively dyspneic, cyanotic, and had jugular venous distension at 90º. The use of the inspiratory musculature was markedly visible, and the respiratory sounds were intensely and diffusely reduced. His heart rate was 104 bpm with regular rhythm, and his blood pressure was 190/100 mmHg. His abdomen was distended and hypertympanic. The lower limbs were not edematous, but signs of chronic venous insufficiency existed. Previous chest X-rays performed during the 4 years preceding his first visit to our hospital showed alterations compatible with mild pulmonary edema ( fig. 1A and 1B).His first arterial blood gas analysis in the ICU showed PO 2 of 26.5 mmHg and PCO 2 of 67.4 mmHg. The diagnosis of respiratory insufficiency was established and a ventilatory prosthesis was installed. The echocardiogram showed preserved systolic function (this result was repeated in all tests performed later, the left ventricular ejection fraction being always above 70%), and pulmonary capillary pressure oscillating from 15 to 23 mmHg in the first 24 hours. The chest X-rays had alterations characteristic of pulmonary congestion. The pulmonary arteriography was negative for thromboembolic disease and showed an increase in the caliber of the pulmonary arteries. A pulmonary biopsy was performed, the result being negative for primary pulmonary disease and compatible with pulmonary edema. In the ICU, the patient received diuretics and vasodilators discontinuously. He improved progressively, which allowed ventilator weaning and discharge from the ICU.Signs of pulmonary congestion persisted on chest computed tomography ...

show abstract

Heart failure and airway obstruction

Cited by 60 publications

References 5 publications

Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

The role of submucosal oedema in increased peripheral airway resistance by intravenous volume loading in dogs

Insuficiência respiratória persistente secundária a insuficiência cardíaca diastólica

Contact Info

Product

Resources

About