Hemodynamic characterization of patients with severe emphysema

被引:288
作者
Scharf, SM
Iqbal, M
Keller, C
Criner, G
Lee, S
Fessler, HE
机构
[1] Long Isl Jewish Med Ctr, Albert Einstein Coll Med, Div Pulm, New Hyde Pk, NY 11042 USA
[2] Long Isl Jewish Med Ctr, Albert Einstein Coll Med, Div Crit Care, New Hyde Pk, NY 11042 USA
[3] St Louis Univ, Sch Med, St Louis, MO 63103 USA
[4] Temple Univ, Sch Med, Philadelphia, PA 19122 USA
[5] Johns Hopkins Med Inst, Baltimore, MD 21205 USA
关键词
emphysema; pulmonary hypertension; cardiovascular function;
D O I
10.1164/rccm.2107027
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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.
引用
收藏
页码:314 / 322
页数:9
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