期刊
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
卷 171, 期 1, 页码 83-87出版社
AMER THORACIC SOC
DOI: 10.1164/rccm.200406-707OC
关键词
hypoxic pulmonary vasoconstriction; magnetic resonance imaging; pulmonary circulation
资金
- NCRR NIH HHS [M01-RR00827] Funding Source: Medline
- NHLBI NIH HHS [HL-17731] Funding Source: Medline
- NATIONAL CENTER FOR RESEARCH RESOURCES [M01RR000827] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [P01HL017731] Funding Source: NIH RePORTER
Uneven hypoxic pulmonary vasoconstriction has been proposed to expose parts of the pulmonary capillary bed to high pressure and vascular injury in high-altitude pulmonary edema (HAPE). We hypothesized that subjects with a history of HAPE would demonstrate increased heterogeneity of pulmonary blood flow during hypoxia. A functional magnetic resonance imaging technique (arterial spin labeling) was used to quantify spatial pulmonary blood flow heterogeneity in three subject groups: (1) HAPE-susceptible (n = 5), individuals with a history of physician-documented HAPE; (2) HAPE-resistant (n = 6), individuals with repeated high-altitude exposure without illness; and (3) unselected (n = 6), individuals with a minimal history of altitude exposure. Data were collected in normoxia and after 5, 10, 20, and 30 minutes of normobaric hypoxia (F-lo2 = 0.125). Relative dispersion (SD/mean) of the signal intensity was used as an index of perfusion heterogeneity. Oxygen saturation was not different between groups during hypoxia. Relative dispersion was not different between groups (HAPE-susceptible 0.94 0.05, HAPE-resistant 0.94 O.OS, unselected 0.87 + 0.06; means SEM) during normoxia, but it was increased by hypoxia in HAPE-susceptible (to 1.10 + 0.05 after 30 minutes, p < 0.0001) but not in HAPE-resistant (0.91 + 0.05) or unselected subjects (0.87 + O.OS). HAPE-susceptible individuals have increased pulmonary blood flow heterogeneity in acute hypoxia, consistent with uneven hypoxic pulmonary vasoconstriction.
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