Document Detail

Exaggerated increase in cardiac output during exercise in patients with peripheral high-flow arteriovenous malformations.
MedLine Citation:
PMID:  21109459     Owner:  NLM     Status:  In-Process    
PURPOSE: To test the hypothesis that cardiac output (Q) in patients with arteriovenous malformations (AVMs) is normal at rest and increases disproportionately during exercise.
MATERIALS AND METHODS: Q was measured in eight patients with large peripheral AVMs and in nine healthy subjects using a noninvasive carbon dioxide (CO₂)-based differential Fick method. Subjects were tested while seated at rest and during mild exercise (repeated leg straightening while sitting). Oxygen consumption (VO₂) was monitored as an index of the degree of exercise.
RESULTS: Average resting Q was similar between AVM patients and healthy subjects (7.40 L/min ± 3.29 vs 6.13 L/min ± 0.94, respectively, P = .29). During exercise, AVM patients showed a smaller increment in VO₂ (0.50 L/min ± 0.11 vs 0.78 L/min ± 0.26, P = .012) but with more apparent effort and shortness of breath compared with healthy subjects. The change in Q per unit change in VO₂ (ΔQ/ΔVO₂) was greater in AVM patients than in healthy subjects (16.00 L/min ± 6.50 vs 9.79 L/min ± 5.33, P < .045).
CONCLUSIONS: Exercise intolerance in AVM patients may be due to an imbalance in ΔQ/ΔVO₂ resulting from increased shunting through the AVM. Exercise provocation may increase the sensitivity of Q in the clinical evaluation of AVM patients.
Alexandra Mardimae; Jay S Han; David Preiss; Lisa Rodrigues; S Murthy Chennapragada; Marat Slessarev; Martin E Simons; Joseph A Fisher
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Publication Detail:
Type:  Journal Article     Date:  2010-11-25
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  22     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.
Department of Anesthesia, University Health Network, University of Toronto, Toronto, Ontario, Canada.
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