Document Detail


The structure and function of the pulmonary vasculature in mild chronic obstructive pulmonary disease. The effect of oxygen and exercise.
MedLine Citation:
PMID:  6625346     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The structure and function of the pulmonary circulation was investigated in 17 patients requiring pulmonary resection. All 17 performed pulmonary function tests and 13 underwent right heart catheterization preoperatively. The surgical specimens of the lung were analyzed with respect to the severity of the emphysema, the severity of the airways disease, and the hypertensive changes in the small pulmonary arteries and arterioles. The data show that pulmonary artery (Ppa) and pulmonary artery wedge (Ppaw) pressures and cardiac output were normal at rest. However, patients with more severe disease showed greater increases in Ppa and Ppaw with exercise than did patients with minimal or no disease. Oxygen breathing had no effect at rest but lowered Ppa and Ppaw during exercise in the patients with more severe disease. Histologic studies showed that greater degrees of emphysema and small airways disease were associated with hypertensive changes in the pulmonary vasculature. We conclude that patients with moderate obstructive lung disease have elevated pulmonary vascular pressures during exercise and structural changes in the pulmonary arteries consistent with pulmonary hypertension when compared with patients with minimal or no disease. Although there are several possible explanations for the increased vascular pressures seen with exercise, we favor gas trapping leading to increased alveolar and pleural pressures, with oxygen breathing preventing this response by shortening the time constants of the peripheral lung units.
Authors:
J L Wright; L Lawson; P D Paré; R O Hooper; D I Peretz; J M Nelems; M Schulzer; J C Hogg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  128     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1983 Oct 
Date Detail:
Created Date:  1983-11-23     Completed Date:  1983-11-23     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  702-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Output
Female
Hemodynamics
Humans
Hypertension, Pulmonary / complications*,  etiology
Lung / blood supply*,  pathology,  physiopathology
Lung Diseases, Obstructive / complications,  physiopathology*
Male
Middle Aged
Oxygen Inhalation Therapy*
Physical Exertion*
Pulmonary Emphysema / complications,  physiopathology
Respiratory Function Tests
Smoking

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


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