Influence of bronchial blood flow and conductance on pulmonary function in stable systolic heart failure

Ceridon, Maile L.; Morris, Norman; Hulsebus, Minelle L.; Olson, Thomas P.; Lalande, Sophie; Johnson, Bruce D.

doi:10.1016/j.resp.2011.04.020

Cited by 16 publications

(16 citation statements)

References 35 publications

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“…However, as can be seen in Table 2, the single breath method tends to yield higher DLNO/DLCO ratios than that of the rebreathe method (presently, mean 5.39 ± 0.43 for single breath vs. 3.58 ± 0.59 for rebreathe), such that approaching the asymptote is not usually an issue. The observation that DLNO/DLCO is slightly higher using the single breath method is found in our laboratory and others (Ceridon et al, 2010; Ceridon et al, 2011; Coffman et al, 2016; Zavorsky and Lands, 2005; Zavorsky and Murias, 2006). …”

Section: Discussionsupporting

confidence: 83%

“…From both of these studies, our laboratory has concluded that the θ CO equation described by Reeves and Park is ideal, while the optimal α value is dependent on the technique used; ~2.26 for rebreathe and ~4.40 for single breath. This difference can be understood by recognizing that the single breath method, in our laboratory and others, often yields DLNO values somewhat higher than the rebreathe method (Ceridon et al, 2010; Ceridon et al, 2011; Coffman et al, 2016; Snyder et al, 2007; Zavorsky et al, 2014; Zavorsky and Murias, 2006; Zavorsky et al, 2004). Of note, while this inconsistency in DLNO values between the two methods in not completely understood, it is not the focus of this manuscript.…”

Section: Methodsmentioning

confidence: 87%

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The blood transfer conductance for nitric oxide: Infinite vs. finite θ NO

Coffman¹,

Chase²,

Taylor

et al. 2017

Respiratory Physiology & Neurobiology

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Whether the specific blood transfer conductance for nitric oxide (NO) with hemoglobin (θNO) is finite or infinite is controversial but important in the calculation of alveolar capillary membrane conductance (DmCO) and pulmonary capillary blood volume (VC) from values of lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO). In this review, we discuss the background associated with θNO, explore the resulting values of DmCO and VC when applying either assumption, and investigate the mathematical underpinnings of DmCO and VC calculations. In general, both assumptions yield reasonable rest and exercise DmCO and VC values. However, the finite θNO assumption demonstrates increasing VC, but not DmCO, with submaximal exercise. At relatively high, but physiologic, DLNO/DLCO ratios both assumptions can result in asymptotic behavior for VC values, and under the finite θNO assumption, DmCO values. In conclusion, we feel that the assumptions associated with a finite θNO require further in vivo validation against an established method before widespread research and clinical use.

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Section: Discussionsupporting

confidence: 83%

Section: Methodsmentioning

confidence: 87%

The blood transfer conductance for nitric oxide: Infinite vs. finite θ NO

Coffman¹,

Chase²,

Taylor

et al. 2017

Respiratory Physiology & Neurobiology

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“…cardiomegaly); the erectile nature of an engorged pulmonary and/or bronchial vasculature; the development of pulmonary interstitial oedema, particularly during exercise; and remodelling of the lung parenchyma due to elevated circulating cytokines and/or chronic hydrostatic insult [18, 41, 50–52]. Although the mechanisms for the lower C L,dyn have been well described in HF, we also noted that compliance of the chest wall in these patients was lower (~18%) than in control subjects.…”

Section: Discussionmentioning

confidence: 99%

The resistive and elastic work of breathing during exercise in patients with chronic heart failure

Cross¹,

Sabapathy²,

Beck

et al. 2011

Eur Respir J

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Patients with heart failure (HF) display numerous derangements in ventilatory function, which together serve to increase the work of breathing (Wb) during exercise. However, the extent to which the resistive and elastic properties of the respiratory system contribute to the higher Wb in these patients is unknown. We quantified the resistive and elastic Wb in patients with stable HF (n=9; New York Heart Association functional class I–II) and healthy control subjects (n=9) at standardised levels of minute ventilation (V′E) during graded exercise. Dynamic lung compliance was systematically lower for a given level of V′E in HF patients than controls (p<0.05). HF patients displayed slightly higher levels of inspiratory elastic Wb with greater amounts of ventilatory constraint and resistive Wb than control subjects during exercise (p<0.05). Our data indicates that the higher Wb in HF patients is primarily due to a greater resistive, rather than elastic, load to breathing. The greater resistive Wb in these patients probably reflects an increased hysteresivity of the airways and lung tissues. The marginally higher inspiratory elastic Wb observed in HF patients appears related to a combined decrease in the compliances of the lungs and chest wall. The clinical and physiological implications of our findings are discussed.

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“…5 Structural and functional alterations of the lungs in HF are well described 5,6 and correlate to HF severity and patient survival. They are linked neurohumourally and hemodynamically (e.g.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary function assessment post‐left ventricular assist device implantation

et al. 2018

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AimThe lungs—and particularly the alveolar‐capillary membrane—may be sensitive to continuous flow (CF) and pulmonary pressure alterations in heart failure (HF). We aimed to investigate long‐term effects of CF pumps on respiratory function.Methods and resultsWe conducted a retrospective study of patients with end‐stage HF at our institution. We analysed pulmonary function tests [e.g. forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)] and diffusing capacity of the lung for carbon monoxide (D LCO) from before and after left ventricular assist device (LVAD) implantation and compared them with invasive haemodynamic studies. Of the 274 patients screened, final study analysis involved 44 patients with end‐stage HF who had CF LVAD implantation between 1 February 2007 and 31 December 2015 at our institution. These patients [mean (standard deviation, SD) age, 50 (9) years; male sex, n = 33, 75%] received either the HeartMate II (Thoratec Corp.) pump (77%) or the HeartWare (HeartWare International Inc.) pump. The mean (SD) left ventricular ejection fraction was 21% (13%). At a median of 237 days post‐LVAD implantation, we observed significant D LCO decrease (−23%) since pre‐implantation (P < 0.001). ΔD LCO had an inverse relationship with changes in pulmonary capillary wedge pressure (PCWP) and right atrial pressure (RAP) from pre‐LVAD to post‐LVAD implantation: ΔD LCO to ΔPCWP (r = 0.50, P < 0.01) and ΔD LCO to ΔRAP (r = 0.39, P < 0.05). We observed other reductions in FEV1, FVC, and FEV1/FVC between pre‐LVAD and post‐LVAD implantation. In mean (SD) values, FEV1 changed from 2.3 (0.7) to 2.1 (0.7) (P = 0.005); FVC decreased from 3.2 (0.8) to 2.9 (0.9) (P = 0.01); and FEV1/FVC went from 0.72 (0.1) to 0.72 (0.1) (P = 0.50). Landmark survival analysis revealed that ΔD LCO from 6 months after LVAD implantation was predictive of death for HF patients [hazard ratio (95% confidence interval), 0.60 (0.28–0.98); P = 0.03].ConclusionsPulmonary function did not improve after LVAD implantation. The degree of D LCO deterioration is related to haemodynamic status post‐LVAD implantation. The ΔD LCO within 6 months post‐operative was associated with survival.

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Influence of bronchial blood flow and conductance on pulmonary function in stable systolic heart failure

Cited by 16 publications

References 35 publications

The blood transfer conductance for nitric oxide: Infinite vs. finite θ NO

The blood transfer conductance for nitric oxide: Infinite vs. finite θ NO

The resistive and elastic work of breathing during exercise in patients with chronic heart failure

Pulmonary function assessment post‐left ventricular assist device implantation

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