Document Detail

A possible role for systemic hypoxia in the reactive component of pulmonary hypertension in heart failure.
MedLine Citation:
PMID:  23273594     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The mechanisms underlying the reactive component of pulmonary hypertension (PH) in heart failure (HF) are unclear. We examined whether resting systemic oxygen levels are related to pulmonary hemodynamics in HF.
METHODS AND RESULTS: Thirty-nine HF patients underwent right heart catheterization. Subsequently, patients were classified as having: 1) no PH (n = 12); 2) passive PH (n = 10); or 3) reactive PH (n = 17). Blood was drawn from the radial and pulmonary arteries for the determination of PaO(2), SaO(2), PvO(2), SvO(2), and vasoactive neurohormones. PaO(2) and PvO(2) were lower in reactive PH versus no PH and passive PH patients (65.3 ± 8.6 vs 78.3 ± 11.4 mm Hg and 74.5 ± 14.0 mm Hg; 29.2 ± 4.1 vs 36.2 ± 2.8 mm Hg and 33.4 ± 2.3 mm Hg; P < .05). SaO(2) and SvO(2) were lower in reactive PH versus no PH patients (93 ± 3% vs 96 ± 3%; 51 ± 11% vs 68 ± 4%; P < .05), but not different versus passive PH patients. The transpulmonary pressure gradient (TPG) was inversely related to PaO(2), PvO(2), SaO(2), and SvO(2) in the reactive PH patients only (r ≤ -0.557; P < .05). Similarly, plasma endothelin-1 correlated with PaO(2), PvO(2), SvO(2) (r ≤ -0.495), and TPG (r = 0.662; P < .05) in reactive PH patients only.
CONCLUSIONS: Systemic hypoxia may play a role in the reactive component of PH in HF, potentially via a hypoxia-induced increase in endothelial release of the vasoconstrictor endothelin-1.
Bryan J Taylor; Cesar R Mojica; Thomas P Olson; Paul R Woods; Robert P Frantz; Bruce D Johnson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  19     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-05-30     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  50-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Anoxia / blood,  diagnosis*,  mortality
Blood Gas Analysis
Cardiac Catheterization / methods
Cardiac Output, Low / physiopathology*
Cohort Studies
Disease Progression
Endothelin-1 / analysis,  blood
Heart Failure / blood*,  mortality,  physiopathology
Hemodynamics / physiology
Hypertension, Pulmonary / blood*,  mortality,  physiopathology
Middle Aged
Multivariate Analysis
Neurotransmitter Agents / analysis,  blood
Oxygen / blood*
Prospective Studies
Regression Analysis
Risk Assessment
Severity of Illness Index
Survival Rate
Vascular Resistance / physiology
Grant Support
Reg. No./Substance:
0/Endothelin-1; 0/Neurotransmitter Agents; S88TT14065/Oxygen

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