Pulmonary Function Tests in Patients with Congestive Heart Failure: Effects of Medical Therapy

Abstract

In a group of 13 patients with severe heart failure, both forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) significantly improved after intensive medical therapy (FVC: from 77 ± 17 to 92 ± 20%, p < 0.001; FEV1: from 65 ± 15 to 81 ± 15%, p < 0.001) in the absence of change in M-mode echo cardiac dimension and left ventricular systolic function; on the other hand, a change of indices of left ventricular filling by Doppler transmitral flow was documented (E/A ratio: from 3.6 ± 1.2 to 1.65 ± 1.5, p < 0.01; early filling deceleration time: from 94 ± 39 to 178 ± 78 ms, p < 0.01), indicating a reduction of pulmonary capillary pressure; this probably positively affected pulmonary interstitial edema and bronchial wall congestion, thus enhancing pulmonary function.

Acute Saline Infusion Reduces Alveolar-Capillary Membrane Conductance and Increases Airflow Obstruction in Patients With Left Ventricular Dysfunction

“…15,17,24 In the present study, saline infusion acutely produced a small but significant reduction in both FEV 1 and PEFR in patients with LVD (Table 3, Figure 3), but not in the normal subjects studied (Table 3). Several factors, either in isolation or in combination, could be responsible for the changes in airflow obstruction observed in patients with LVD, as follows.…”

“…Some workers have proposed that accumulation of subclinical interstitial edema, a potentially reversible factor, might contribute to the reduced DLCO seen in chronic heart failure. 1,15,16 The aim of this study was to test the sensitivity of pulmonary gas transfer as measured by DLCO and its subdivisions to acute isotonic intravascular volume expansion in patients with significant left ventricular dysfunction (LVD) compared with normal subjects. In addition, because airway obstruction occurs in patients with decompensated heart failure and improves with diuretic therapy, 15,17 we wished to examine the effects of acute volume loading on lung spirometry and peak expiratory flow rate (PEFR) measurements.…”

Preoperative, İntraoperative and Postoperative Predictors of Postoperative Respiratory System Complications in Patients Undergoing Open Heart Surgery

“…Birçok araştırmada kronik sol ventrikül fonksiyonu bozuk olan hastalarda restriktif ve obstruktif tipte akciğer fonksiyon bozukluklarının olabileceği gösteril-miştir (12,14) . KKY olan hastalarda akciğer kompliyansının azaldığı gösteren çalışmalarda mevcuttur (15,16) . KKY bulunan hastalarda efor kapasitesinin sınırlı olması ve inspiryum kapasitelerinin azalması nedeniyle bu tip komplikasyonların ortaya çıkmasını kolaylaş-tırmaktadır.…”

Pulmonary Function Testing and Outcomes in Subjects With Heart Failure Listed for Heart Transplantation

“…41 With medical therapy, there is significant improvement in restrictive or obstructive abnormalities, and this improvement is explained by a reduction of pulmonary pressures, with a subsequent decrease in interstitial edema and bronchial wall congestion. 14,39,42 Our study has some important limitations. There were no available spirometric data on all listed subjects.…”