Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 166, Issue 3, Pages 314-322Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.2107027
Keywords
emphysema; pulmonary hypertension; cardiovascular function
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Funding
- NHLBI NIH HHS [N01 HR 76108, N01 HR 76115, HR 97-02, N01 HR 76106] Funding Source: Medline
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In 120 patients with severe emphysema evaluated for participation in the National Emphysema Treatment Trial, pulmonary hemodynamics and ventricular function were assessed. Pulmonary function tests were (%predicted): FEV, = 27%; residual volume = 224.6%; diffusion capacity 26.7%. In 90.8% of patients, end-expiratory pulmonary artery mean pressure was > 20 mm Hg; in 61.4%, end-expiratory wedge pressure was > 12 mm Hg. Cardiac index was normal. Mean pulmonary artery pressure correlated inversely with arterial Po-2, and severity of emphysema, and directly with wedge pressure. Multiple stepwise regression revealed that arterial Po-2 was not an independent predictor of mean pulmonary artery pressure. No correlation was found between indices of emphysema severity and PA pressures. Diastolic ventricular pressures were increased without evidence of systolic dysfunction. We conclude that (1) elevations of pulmonary vascular pressures are common, (2) pulmonary hypertension may be related to factors other than hypoxia, (3) pulmonary hypertension does not impair resting systemic O-2 delivery, and (4) elevated cardiac diastolic pressures do not represent systolic dysfunction.
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