| Impaired matching of perfusion and ventilation in heart failure detected by 133xenon. | |
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MedLine Citation:
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PMID: 8896743 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In severe chronic heart failure (CHF) the ventilatory cost of CO2 elimination during exercise (VE/VCO2) is increased, suggesting ventilation/perfusion (V/Q) mismatch. The relationship of exercise VE/VCO2 regression slope m to deadspace ventilation was studied in 15 patients with CHF who underwent cardiopulmonary exercise testing and arterial blood gas monitoring. Regional lung ventilation and perfusion was studied, using 133xenon, at rest and peak exercise in a further group of 10 CHF patients and in five normal subjects. VE/VCO2 slope m correlated well with deadspace ventilation at peak exercise in the 15 patients with CHF. We therefore used exercise VE/VCO2 slope m to categorize CHF patients undergoing 133xenon imaging into groups with increased (slope m > 36) or normal (slope m < 36) exercise deadspace ventilation. In normals, resting V/Q determined by 133xenon showed a gravitational gradient, which improved on exercise as a result of relative increases and of relative reductions in regional perfusion; no significant changes in regional ventilation distribution were detected. In patients with CHF who had normal slope m (n = 5), rest and exercise V/Q were similar to the normal subjects. In CHF patients with increased slope m (n = 5) however, the resting gravitational gradient of V/Q was lost, and there were no significant changes in relative perfusion distribution on exercise. These findings suggest that the increased ventilatory cost of CO2 elimination found in certain patients with CHF is related to inability to coordinate and optimise the relative distribution of lung perfusion with respect to ventilation during exercise. |
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Authors:
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N P Lewis; A P Banning; J P Cooper; A S Sundar; P E Facey; W D Evans; A H Henderson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Basic research in cardiology Volume: 91 Suppl 1 ISSN: 0300-8428 ISO Abbreviation: Basic Res. Cardiol. Publication Date: 1996 |
Date Detail:
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Created Date: 1997-01-28 Completed Date: 1997-01-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0360342 Medline TA: Basic Res Cardiol Country: GERMANY |
Other Details:
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Languages: eng Pagination: 45-9 Citation Subset: IM |
Affiliation:
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Andrew H. Henderson Cardiopulmonary Transplant Center, University of Virginia Health Sciences Center, Charlottesville 22906, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Carbon Dioxide / metabolism Exercise Test Heart Failure / blood, physiopathology*, radionuclide imaging* Humans Male Middle Aged Oxygen / blood Pulmonary Ventilation* Xenon Radioisotopes / diagnostic use* |
| Chemical | |
Reg. No./Substance:
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0/Xenon Radioisotopes; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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