Document Detail

Diurnal variation in FEV1 after heart-lung transplantation.
MedLine Citation:
PMID:  1499707     Owner:  NLM     Status:  MEDLINE    
We have examined the diurnal variation in forced expiratory volume in one second (FEV1) in 25 heart-lung transplantation patients over a four week period in order to study the pathophysiological mechanisms underlying the increased mortality and morbidity which occurs at night in asthma. These patients do not have pulmonary autonomic nervous reflexes, but often have muscarinic receptor hypersensitivity. They also develop mixed cell infiltration of the lung tissue in the course of infection or rejection. Thus, they show many features in common with asthma. Seventeen patients (68%) showed a significant diurnal variation in airway calibre (mean amplitude of FEV1 was 4.6% (SD 3.7%)), which is similar to that reported in normal adults. One patient had a diurnal variation of 34.5% during an episode of rejection. This variation fell to 6.9% after steroid therapy, a change often seen in asthma. There was a correlation between increased amplitude of the variation and the presence in transbronchial biopsies of airway submucosal eosinophils and lymphocytes, associated with a histological diagnosis of acute rejection and with epithelial damage. No association was seen with muscarinic receptor sensitivity. The variation in FEV1 showed no alteration from the normal day/night synchronization, and the peak values were around 1300 h. We conclude that the diurnal variation in FEV1 after heart-lung transplantation is not dependent on autonomic nerve reflexes or muscarinic receptor sensitivity, but is related to the consequences of inflammation described above.
J F Morrison; T W Higenbottam; T J Hathaway; C Clelland; J P Scott; J Wallwork
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The European respiratory journal     Volume:  5     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-09-11     Completed Date:  1992-09-11     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  834-40     Citation Subset:  IM    
Dept of Respiratory Physiology, Papworth Hospital, Cambridge, UK.
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MeSH Terms
Airway Resistance / physiology
Asthma / physiopathology
Autonomic Nervous System / physiology
Circadian Rhythm / physiology*
Forced Expiratory Volume / physiology*
Graft Rejection / physiology
Heart-Lung Transplantation / physiology*
Prednisolone / therapeutic use
Receptors, Muscarinic / physiology
Reflex / physiology
Reg. No./Substance:
0/Receptors, Muscarinic; 50-24-8/Prednisolone

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