+ Translate

The pressure-flow response of the pulmonary circulation in patients with heart failure and pulmonary vascular disease

, : The pressure-flow response of the pulmonary circulation in patients with heart failure and pulmonary vascular disease. Circulation 72(6): 1270-1278

Although it is well known that the pulmonary circulation is altered in patients with pulmonary arterial or venous hypertension, the resultant hemodynamic behavior has not been systematically studied. We undertook to do so in a group of patients with pulmonary hypertension of diverse etiology. We measured pulmonary arterial (PAP) and occlusive wedge pressures and cardiac output at rest (i.e., standing) and during progressive upright treadmill exercise in 51 patients. Forty-two had chronic, stable, cardiac failure secondary to ischemic, myopathic or valvular heart disease and were grouped according to whether their mean PAP was less than (normotensive) or greater than (hypertensive) 19 mm Hg, and nine had pulmonary vascular disease of diverse etiology and were considered separately. In the majority of patients, we found that irrespective of whether the hypertension was arterial or venous in origin or etiology: the mean PAP-flow relationship was linear; pulmonary capillary wedge pressure was greater than or equal to the average closure pressure of the pulmonary vascular bed and could therefore be used as the downstream pressure in calculating pulmonary vascular resistance; and pulmonary vascular resistance declined with exercise. Notable exceptions to the third observation were patients with valvular heart disease or a resting pulmonary vascular resistance greater than 800 dyne-sec-cm-5.

(PDF 0-2 workdays service)

Accession: 041720380

PMID: 4064271

Submit PDF Full Text: Here

Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:

Related references

Fratz, S.; Geiger, R.; Kresse, H.; Roemer, G.; Hennig, M.; Sebening, W.; Hess, J., 2003: Pulmonary blood pressure, not flow, is associated with net endothelin-1 production in the lungs of patients with congenital heart disease and normal pulmonary vascular resistance. Endothelin-1 concentrations are increased in patients with increased mean pulmonary arterial pressure, pulmonary blood flow, and pulmonary vascular resistance. However, endothelin-1 concentrations have not been well characterized in patients with...

Yamamoto, T.; Okada, O.; Tanabe, N.; Yasuda, J.; Satou, K.; Saitou, M.; Yoshida, Y.; Katou, K.; Kuriyama, T., 1994: Relation of pulmonary vascular response to pressure-flow relationship during incremental exercise in patients with chronic obstructive pulmonary disease (COPD). Twenty-eight COPD patients underwent right heart catheterization while in clinically stable condition. Pulmonary vascular response to oxygen was evaluated by the percent change in pulmonary arteriolar resistance after 100% oxygen inhalation (% del...

Tsutamoto, T.; Wada, A.; Kinoshita, M., 1992: Correlation between endothelin-1 production in pulmonary circulation and the pulmonary vascular resistance in patients with chronic heart failure. Circulation 86(4 SUPPL 1): I50

Kubo S.H.; Cody R.J.; Burchenal J.E.B., 1986: Heterogeneity of pulmonary vascular resistance response to exercise in congestive heart failure influence of pulmonary driving pressure. Clinical Research 34(2): 317A

Pande, A.; Sarkar, A.; Ahmed, I.; Naveen Chandra, G.; Patil, S.Kumar.; Kundu, C.Kumar.; Arora, R.; Samanta, A., 2014: Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow. Pulmonary vascular resistance (PVR) is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. The present study was...

Krahnke, J.S.; Abraham, W.T.; Adamson, P.B.; Bourge, R.C.; Bauman, J.; Ginn, G.; Martinez, F.J.; Criner, G.J., 2015: Heart failure and respiratory hospitalizations are reduced in patients with heart failure and chronic obstructive pulmonary disease with the use of an implantable pulmonary artery pressure monitoring device. Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients with heart failure (HF). Elevated pulmonary arterial (PA) pressure can be seen in both conditions and has been shown to predict morbidity and mortality. A total of...

Capomolla, S.; Pozzoli, M.; Gola, A.; Maestri, R.; Sisti, M.; Cobelli, F.; Tavazzi, L., 1996: Pulmonary venous flow in patients with chronic heart failure: feasibility and additional value compared to transmitral flow for non-invasive estimation of pulmonary wedge pressure. In many cardiac conditions, Doppler of transmitral flow has been showed to be related to left ventricular filling pressure, but several factors may limit its practical value in estimating pulmonary wedge pressure in patients with chronic heart fai...

Seibold, H.; Wieshammer, S.; Kress, P., 1988: Relation of pressure and flow of pulmonary circulation in patients with chronic obstructive pulmonary disease. A series of 31 patients with various degrees of chronic obstructive pulmonary disease underwent right heart catheterization using flow-directed thermodilution catheters. Both rest and supine exercise values were obtained. The patients were divided...

Kleber, F.X.; Wensel, R.; Felix, S.B.; Reindl, I.; Baumann, G., 1996: Acetylcholine causes dose dependent increase in pulmonary flow in patients with chronic heart failure and elevated pulmonary vascular resistance. Elevated pulmonary vascular resistances occur to a variable degree in patients with chronic congestive heart failure (CHF). These might be caused by increased levels of endogenous vasoconstrictors, defective endothelial vasodilatory mechanisms or...

Bech-Hanssen, O.; Fadel, B.; A.H.beeb, W.; A.B.raiki, J.; Selimovic, N., 2014: Pressure reflection in the pulmonary circulation by echocardiography in patients with left heart disease indicates reactive pulmonary hypertension. The two hemodynamic profiles in left heart disease (LHD) with pulmonary hypertension (PH), passive PH with increased pulmonary venous pressure and reactive PH with increased pulmonary vascular resistance (PVR > 3 Wood units, WU), are difficult...