Document Detail


Exercise-induced pulmonary edema in heart failure.
MedLine Citation:
PMID:  14581402     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In heart failure (HF) patients, exercise may increase pulmonary capillary hydrostatic pressure and thereby generate pulmonary edema. If pulmonary edema developed, alveolar-capillary membrane conductance (Dm), measured immediately after exercise, would decrease. To test this hypothesis, we measured Dm before and at 2 and 60 minutes after exercise. METHODS AND RESULTS: We studied 10 HF patients with exercise-induced periodic breathing, 10 with peak o2 < or =15 mL x min(-1) x kg(-1) (severe HF), 10 with o2=15 to 20 mL x min(-1) x kg(-1) (moderate HF), and 10 normal subjects (control). Using the Roughton-Forster technique, we measured carbon monoxide diffusion capacity (DLco) and its components, capillary blood volume (Vc) and Dm, at rest and 2 and 60 minutes after exercise. At rest, DLco and Dm were lowest in periodic breathing and highest in control subjects. Dm decreased in periodic breathing, severe HF, and moderate HF (-7.83+/-3.98, -5.57+/-2.03, and -3.85+/-3.53 mL x min(-1) x mm Hg(-1), respectively; P<0.01) at 2 minutes after exercise but not in control subjects. Vc increased in all groups at 2 minutes and remained elevated at 60 minutes only in periodic breathing. Dm/Vc was decreased in periodic breathing, severe HF, and moderate HF at 2 minutes but not in control subjects. Dm and Dm/Vc remained low at 60 minutes only in periodic breathing. CONCLUSIONS: Dm decreases after exercise in HF patients but not in control subjects, which suggests a decrease in conductance across the alveolar-capillary barrier, as with pulmonary edema. The reductions were most marked in HF patients with periodic breathing and less reduced in less severe HF.
Authors:
Piergiuseppe Agostoni; Gaia Cattadori; Michele Bianchi; Karlman Wasserman
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article     Date:  2003-10-27
Journal Detail:
Title:  Circulation     Volume:  108     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-25     Completed Date:  2003-12-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2666-71     Citation Subset:  AIM; IM    
Affiliation:
Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, Via Parea 4, 20138 Milan, Italy. Piergiuseppe.agostoni@CCFM.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Volume
Carbon Monoxide / metabolism
Cell Membrane / physiology
Diagnostic Techniques, Cardiovascular
Diffusion
Electric Conductivity
Exercise Test / adverse effects*
Female
Heart Failure / complications,  physiopathology*
Humans
Male
Middle Aged
Physical Exertion*
Pulmonary Alveoli / blood supply,  physiopathology
Pulmonary Circulation
Pulmonary Edema / diagnosis*,  etiology,  physiopathology*
Reference Values
Time Factors
Chemical
Reg. No./Substance:
630-08-0/Carbon Monoxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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