The circulation in patients with chronic bronchitis and emphysema at rest and during exercise, with special reference to the influence of changes in blood viscosity and blood volume on the pulmonary circulation.

Segel, N; Bishop, J. M.

doi:10.1172/jci105462

Cited by 109 publications

(44 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since the group of patients was homogenous in most respects, the data are therefore of value when considering the effects of disturbances of these physiological parameters on plasma irANF levels and on their interrelation in COLD. The predominant stimulus affecting ANF (46). These observations are consistent with our findings of a correlation between plasma irANF levels and pulmonary artery pressure or hemoglobin concentration but not with cardiac filling pressures in such patients.…”

Section: Discussionsupporting

confidence: 92%

“…These observations are consistent with our findings of a correlation between plasma irANF levels and pulmonary artery pressure or hemoglobin concentration but not with cardiac filling pressures in such patients. These findings would also suggest that polycythemia might have contributed to stimulate ANF secretion in our patients via an increase in both central blood volume and pulmonary artery pressure (46,47). The degree of hypercapnic acidosis appeared as another important physiological stimulus for ANF secretion in patients with COLD.…”

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Atrial natriuretic factor in chronic obstructive lung disease with pulmonary hypertension. Physiological correlates and response to peptide infusion.

Adnot

Andrivet²,

Chabrier³

et al. 1989

J. Clin. Invest.

View full text Add to dashboard Cite

To investigate the physiological role of atrial natriuretic factor (ANF) in patients with hypoxic pulmonary hypertension secondary to chronic obstructive lung disease (COLD), we infused synthetic a-human ANF in seven such patients, and investigated the physiological correlates to circulating peptide levels in 24 patients with COLD.ANF infusion, at incremental rates of 0.01, 0.03, and 0.1 Mg/kg . min, increased basal plasma immunoreactive (ir) ANF (136±38 pg/ml) by 3-, 10-, and 26-fold, respectively, and reduced pulmonary artery pressure (from 33±3 to 25±2 mmHg, P < 0.001) and systemic arterial pressure (from 88±4 to 79±4 mmHg, P < 0.001) in a dose-related fashion. Cardiac index increased by 13.5% (P < 0.01) while heart rate was unchanged. Cardiac filling pressures decreased at 0.1 Mg/kg min ANF. Pulmonary and systemic vascular resistance fell by 37% (P < 0.001) and 19% (P < 0.001), respectively. Arterial oxygenation was impaired during ANF infusion, suggesting partial reversal of hypoxic pulmonary vasoconstriction. Plasma renin activity remained unchanged but aldosterone fell by 44% (P < 0.01).The levels of plasma irANF in 24 patients correlated directly with the degree of hemoconcentration (r = 0.67, P < 0.001), respiratory acidosis (r = -0.65, P < 0.001), and pulmonary hypertension (r = 0.52, P < 0.01). The results suggest that ANF may serve as a potent pulmonary vasodilator involved in the circulatory homeostasis of patients with COLD.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 81%

Atrial natriuretic factor in chronic obstructive lung disease with pulmonary hypertension. Physiological correlates and response to peptide infusion.

Adnot

Andrivet²,

Chabrier³

et al. 1989

J. Clin. Invest.

View full text Add to dashboard Cite

show abstract

“…Moreover, in numerous studies, functional benefits of phlebotomy in hypoxic pulmonary disease have been described. [10][11][12][13][14][15][16] Conversely, polycythemia contributes to the development of cor pulmonale and pulmonary hypertension, which are linked to poor prognosis. 17 However, most of these studies were performed prior to the widespread use of LTOT and domiciliary noninvasive ventilation (NIV), and large systematic trials on phlebotomy in polycythemic patients are lacking.…”

Section: Introductionmentioning

confidence: 99%

Hemoglobin Levels Above Anemia Thresholds Are Maximally Predictive for Long-Term Survival in COPD With Chronic Respiratory Failure

et al. 2012

View full text Add to dashboard Cite

BACKGROUND: In patients with COPD, chronic anemia is known as an unfavorable prognostic factor. Whether the association between hemoglobin (Hb) levels and long-term survival is restricted to anemia or extends to higher Hb levels has not yet been systematically assessed. METHODS: We determined Hb levels in 309 subjects with COPD and chronic respiratory failure prior to initiation of noninvasive ventilation, accounting for confounders that might affect Hb. Subjects were categorized as anemic (Hb < 12 g/dL in females, Hb < 13 g/dL in males), polycythemic (Hb > 15 g/dL in females, Hb > 17 g/dL in males), or normocythemic. In addition, percentiles of Hb values were analyzed with regard to mortality from any cause. RESULTS: Two-hundred seven subjects (67.0%) showed normal Hb levels, 46 (14.9%) had anemia, and 56 (18.1%) had polycythemia. Polycythemic subjects showed a higher survival rate than anemic (P ‫؍‬ .01) and normocythemic subjects (P ‫؍‬ .043). In a univariate Cox hazards model, Hb was associated with long-term survival (hazard ratio 0.855; 95% CI 0.783-0.934, P < .001). The 58th percentiles of Hb (14.3 g/dL in females, 15.1 g/dL in males) yielded the highest discriminative value for predicting survival (hazard ratio 0.463, 95% CI 0.324 -0.660, P < .001). In the multivariate analysis this cutoff was an independent predictor for survival (hazard ratio 0.627, 95% CI 0.414 -0.949, P ‫؍‬ .03), in addition to age and body mass index. CONCLUSIONS: In subjects with COPD and chronic respiratory failure undergoing treatment with noninvasive ventilation and LTOT, high Hb levels are associated with better long-term survival. The optimal cutoff level for prediction was above the established threshold defining anemia. Thus, predicting survival only on the basis of anemia does not fully utilize the prognostic potential of Hb values in COPD.

show abstract

“…16 However, to date, few clinical studies have evaluated the relationship between blood viscosity, polycythaemia and PH, although the effect of haematocrit on pulmonary pressure has been reported. [17][18][19] A retrospective analysis of 41 patients with emphysema revealed that increasing levels of Hb correlated with increasing PAP. 20 In contrast, some investigators have reported that augmentation of polycythaemia by exogenous human recombinant erythropoietin failed to worsen the severity of hypoxic pulmonary hypertension in rats.…”

Section: Discussionmentioning

confidence: 99%

“…32 Furthermore, an increase in blood volume by infusing albumin in COPD patients without polycythaemia resulted in a rise in both PAP and cardiac output, but no change in pulmonary vascular resistance. 19 Prior to the development of secondary polycythaemia due to long-standing hypoxaemia in COPD patients, anaemia could be a more important driver of elevated PAP. It may be that Hb concentration and PAP have a 'U-shape relationship' in COPD.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia

Lee¹,

Oh²,

Seo

et al. 2011

int j tuberc lung dis

View full text Add to dashboard Cite

THE DEVELOPMENT of pulmonary hypertension (PH) is often observed in advanced chronic obstructive pulmonary disease (COPD) and indicates a poor prognosis, with a 5-year survival rate of 20-36%. 1,2 PH primarily occurs in COPD patients with severe hypoxaemia; fortunately, however, the PH is typically mild. 3 Hypoxaemia increases pulmonary artery pres- S U M M A R Ysure (PAP) through hypoxic pulmonary vasoconstriction and vascular remodelling. 4 However, there is a poor correlation between lung function parameters and PAP, suggesting that factors other than airway obstruction and/or loss of alveolar surface may play a role in its aetiology.Recent studies have shown that a proportion of patients with only moderate airway obstruction have severe PH. 5,6 Disproportionate PH in COPD patients seems best defi ned as at least moderate elevation in SDL and YMO contributed equally to this article.

show abstract

The circulation in patients with chronic bronchitis and emphysema at rest and during exercise, with special reference to the influence of changes in blood viscosity and blood volume on the pulmonary circulation.

Cited by 109 publications

References 36 publications

Atrial natriuretic factor in chronic obstructive lung disease with pulmonary hypertension. Physiological correlates and response to peptide infusion.

Atrial natriuretic factor in chronic obstructive lung disease with pulmonary hypertension. Physiological correlates and response to peptide infusion.

Hemoglobin Levels Above Anemia Thresholds Are Maximally Predictive for Long-Term Survival in COPD With Chronic Respiratory Failure

Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia

Contact Info

Product

Resources

About