Pulmonary Hemodynamics in Obstructive Lung Disease

Lim, Thomas P. K.; Brownlee, William E.

doi:10.1378/chest.53.2.113

Cited by 27 publications

(14 citation statements)

References 13 publications

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“…This is in agreement with reports of many workers in this field [6,16,20,24,25], indicating that left-heart disease was not a prominent factor in our patients with COPD with regard to the mean values. Nevertheless, 5 of the 27 patients showed a disproportionately high pulmonary capil lary pressure during exercise, suggestingbut not proving -occult left-heart disease.…”

Section: Exercise Tolerance and The Relationship To Lung Function Andsupporting

confidence: 94%

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Pulmonary Gas Exchange and Central Hemodynamics at Rest and during Exercise in Patients with Chronic Obstructive Pulmonary Disease

Seibold¹,

Roth²,

Lippert³

et al. 1986

Respiration

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Right-heart catheterization and ergometry with arterial and mixed venous blood gas analysis were performed in 27 patients with a wide range of chronic obstructive pulmonary diseases. The purpose of the examination was to evaluate the risk in patients for lung surgery or to detect additional heart diseases. Patients who developed ex-ertional hypoxia (group 1) were compared with others who did not (group 2). In all patients the steady-state maximal workload was determined by ventilatory dysfunction. Both groups had normal values for mixed venous pO₂ and normal increase of the circulatory parameters during exercise. The patients with exertional hypoxia differed from the others in that they showed no decrease of venous admixture and alveolar-arterial oxygen gradient. In addition, these patients had increasing pCO₂ values at rest compared with exercise, indicating alveolar hypoventilation and ventilation-perfusion mismatching. Because of the good correlation of the absolute values of FEV₁ (forced expiratory volume in 1 s) with pulmonary artery pressures, parameters of gas exchange and working capacity, this lung function parameter seems to have a central role in predicting the functional state of patients with chronic obstructive disease. Ergometry and blood gas analysis should be performed in addition because these values cannot be predicted with the calculated postoperative FEV₁

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Section: Exercise Tolerance and The Relationship To Lung Function Andsupporting

confidence: 94%

“…In the early stage of the disease, pulmonary hypertension occurs predomi nantly during exercise [5,6,24). With time, right ventricular hypertrophy and failure, intensified by bronchial infections, can develop.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Gas Exchange and Central Hemodynamics at Rest and during Exercise in Patients with Chronic Obstructive Pulmonary Disease

Seibold¹,

Roth²,

Lippert³

et al. 1986

Respiration

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show abstract

“…This could be due to higher inspiratory pressures used for BiPAP since increased intrathoracic pressure may influence MPWP [14, 15]and LV filling pressure. In the present study, since MPWP exhibited only small variations during increased intrathoracic pressures, a decrease of LV filling pressure could have happened.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Effects of Bilevel Nasal Positive Airway Pressure Ventilation in Patients with Heart Failure

Philip-Joët

Paganelli²,

Dutau³

et al. 1999

Respiration

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Aims: Benefits of nasal continuous positive airway pressure (CPAP) in patients presenting with chronic heart failure (CHF) are controversial. The purpose of this study was to compare the hemodynamic effects of CPAP and bilevel positive airway pressure (BiPAP) in patients with or without CHF. Methods and Results: Twenty patients with CHF and 7 with normal left ventricular function underwent cardiac catheterization. Measurements were made before and after three 20-min periods of BiPAP: expiratory positive airway pressure (EPAP) = 8 cm H₂O and inspiratory positive airway pressure (IPAP) = 12 cm H₂O, EPAP = 10 cm H₂O and IPAP = 15 cm H₂O, and CPAP = EPAP = IPAP = 10 cm H₂O administered in random order. Positive pressure ventilation decreased cardiac output (CO) and stroke volume. No change was observed in either pulmonary or systemic arterial pressure. There was no difference in the hemodynamic effects of the three ventilation settings. Only mean pulmonary wedge pressure (MPWP) and heart rate were lower with CPAP than with BiPAP. CO decreased only in patients with low MPWP (≤12 mm Hg). BiPAP ventilation increased PaO₂ and decreased PaCO₂ more than CPAP. Conclusions: In patients with cardiac failure, a decrease in CO occurs both during CPAP and BiPAP, when pulmonary wedge pressure is low (≤12 mm Hg).

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“…The pulmonary arterial wedge pressure in exercise was found elevated in a significant number of patients [7,9,13,14,[17][18][19][20]22], particularly in those with marked pulmonary arterial hypertension and RHF. The pos sible complex mechanisms of increased Ppaw.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Function and Pulmonary Hemodynamics During Exercise in Patients with Chronic Obstructive Bronchopulnonary Disease

Ježek

Schrijen

Sadoul³

1973

Cardiology

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Central hemodynamics were examined in 50 patients with chronic obstructive bronchopulmonary disease at rest and during mild steady-state supine exercise. The cardiac output rose proportionally to increased oxygen uptake in most cases; there was no difference between the patients with and without chronic right heart failure (RHF). The mean pulmonary arterial pressure in exercise increased disproportionally to cardiac output in about half of the compensated patients and in all cases with RHF. The pulmonary vascular resistance did not change significantly. The right ventricular end-diastolic pressure (RVEDP) at rest was significantly higher in the patients with RHF than in the other but the individual variations were large. Thus, the resting RVEDP cannot be considered as a reliable sign of RV functional abnormality in individual cases. Better agreement with clinical classification of the patients was obtained when considering the exercise values of RVEDP and particularly the relation of RVEDP to stroke volume during exercise.

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Pulmonary Hemodynamics in Obstructive Lung Disease

Cited by 27 publications

References 13 publications

Pulmonary Gas Exchange and Central Hemodynamics at Rest and during Exercise in Patients with Chronic Obstructive Pulmonary Disease

Pulmonary Gas Exchange and Central Hemodynamics at Rest and during Exercise in Patients with Chronic Obstructive Pulmonary Disease

Hemodynamic Effects of Bilevel Nasal Positive Airway Pressure Ventilation in Patients with Heart Failure

Right Ventricular Function and Pulmonary Hemodynamics During Exercise in Patients with Chronic Obstructive Bronchopulnonary Disease

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