INCREASED EXTRAVASCULAR LUNG WATER IN PATIENTS WITH LOW PULMONARY-ARTERY OCCLUSION PRESSURE AFTER ACUTE MYOCARDIAL-INFARCTION

Objective: To evaluate the clinical characteristics of increased extravascular lung water (EVLW) in patients with low pulmonary artery occlusion pressure (PAOP) in the early phase of acute myocardial infarction. Design: Consecutive sample for descriptions of the clinical features of medical disorders. Setting: A general medicine group practice in a university hospital. Patients: Sixteen patients with low PAOP (< 18 mm Hg) on the initial measurement obtained within 12 hr of chest pain onset. Measurements and Main Results: EVLW was measured by the thermal indocyanine green dye double-indicator dilution method. QRS score was obtained on hospital day 7 from the Selvester's QRS Scoring System. Eleven (69%) patients had increased EVLW > 7 mL/kg despite low PAOP. EVLW had no significant correlation with PAOP and the difference between plasma colloid osmotic pressure and PAOP, but did have a significant correlation with pulmonary vascular resistance index (r2 = .31, p < .05), and QRS score (r2 = .45, p < .005). Conclusions: Larger infarcts led to increased EVLW even with low PAOP, and the accumulation of increased EVLW around the small arterioles might have led to increased pulmonary vascular resistance.