Hemodynamic characterization of patients with severe emphysema

Steven M. Scharf, Mobeen Iqbal, Cesar Keller, Gerald Criner, Shing Lee, Henry E. Fessler

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Abstract

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): FEV1 = 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 Po2, and severity of emphysema, and directly with wedge pressure. Multiple stepwise regression revealed that arterial Po2 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 O2 delivery, and (4) elevated cardiac diastolic pressures do not represent systolic dysfunction.

Original languageEnglish (US)
Pages (from-to)314-322
Number of pages9
JournalAmerican journal of respiratory and critical care medicine
Volume166
Issue number3
DOIs
StatePublished - Aug 1 2002

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Keywords

  • Cardiovascular function
  • Emphysema
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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