Document Detail


Impaired pulmonary diffusion during exercise in patients with chronic heart failure.
MedLine Citation:
PMID:  10500041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary diffusion is impaired at rest in patients with chronic heart failure (CHF) and has been implicated in the generation of symptoms and exercise intolerance. The aim of this study was to determine whether pulmonary diffusion is impaired during exercise in CHF, to examine its relationship to pulmonary blood flow, and to consider its functional significance in relation to metabolic gas exchange. METHODS AND RESULTS: Carbon monoxide transfer factor (TLCO) and pulmonary blood flow (Q(C)) were measured by a rebreathe technique at rest and during steady-state cycling at 30 W in 24 CHF patients and 10 control subjects. Both patients and control subjects were able to raise TLCO and Q(C) during exercise. However, the patient group had a lower diffusion for a given blood flow (TLCO/Q(C)) both at rest (3.6+/-0.16 and 4.8+/-0.23 mL x L(-1) x mm Hg(-1); P<0.001) and during exercise (2.8+/-0.16 and 3.4+/-0.13 mL x L(-1) x mm Hg(-1) for CHF patients and control subjects, respectively; P<0.05). TLCO/Q(C) was related to the ventilatory equivalent for carbon dioxide (VEVCO(2)) production at 30 W (TLCO/Q(c) versus VEVCO(2), r = -0.58, P<0.01) and to peak exercise oxygen consumption measured during a progressive test (TLCO/Qc versus VO(2peak), r = 0.57, P<0.01) in these patients. CONCLUSIONS: Patients with CHF are able to recruit reserves of TLCO and Q(C) during exercise. However, the TLCO/Q(C) ratio is consistently impaired in these patients and relates to both exercise hyperpnea and peak exercise oxygen consumption. Whether this impairment in alveolar gas exchange is reversible in CHF and therefore is a potential target for therapy has yet to be determined.
Authors:
A A Smith; P J Cowburn; M E Parker; M Denvir; S Puri; K R Patel; J G Cleland
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  100     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-20     Completed Date:  1999-10-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1406-10     Citation Subset:  AIM; IM; S    
Affiliation:
Clinical Research Initiative in Heart Failure, Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, UK.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output, Low / physiopathology*
Chronic Disease
Exercise*
Exercise Test
Homeostasis
Humans
Lung / physiopathology
Male
Middle Aged
Pulmonary Circulation
Pulmonary Diffusing Capacity*
Rest

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


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