Influence of bronchial blood flow and conductance on pulmonary function in stable systolic heart failure
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Background The aim of this study was to determine the relationship between airway blood flow View the MathML source, airway conductance (Gf-aw) and pulmonary function in patients with stable HF. Methods 12 controls (CTRL: age = 63 ᠹ years, FVC = 98 ᠱ5%pred, LVEF = 61 ᠶ%) (all data presented as mean ᠓D), 16 patients with mild HF (HF-A, NYHA I-II: age = 64 ᠹ years, FVC = 90 ᠱ7%pred, LVEF = 28 ᠶ%), and 14 patients with moderate/severe HF (HF-B, NYHA III-IV: age = 65 ᠶ years, FVC = 84 ᠱ2%pred, LVEF = 26 ᠶ%) were studied. View the MathML source was assessed using soluble gas measurements; perfusion pressure across airway bed (?Paw) was estimated from systemic and pulmonary pressure measurements; Gf-aw was calculated as View the MathML source; PF was assessed by spirometry. Results While View the MathML source was not significantly different between CTRL (61.3 ᠱ7.9 匠min-1 mL-1), HF-A (70.1 ᠲ6.9 匠min-1 mL-1) and HF-B (56.2 ᠱ4.9 匠min-1 mL-1) groups, Gf-aw, was elevated in HF-A (1.1 ᠰ.4 匠min-1 mL-1 mmHg-1, p < 0.03) and tended to be elevated in HF-B (1.2 ᠰ.6 匠min-1 mL-1 mmHg-1, p = 0.07) when compared to CTRL (0.8 ᠰ.3 匠min-1 mL-1 mmHg-1). Significant positive correlations were found between Gf-aw and RV/TLC for HF-A (r = 0.63, p < 0.02) and HF-B (r = 0.58, p < 0.05). Conclusions These results support the hypothesis that increased bronchial conductance and bronchial congestion may be related to greater small airway obstruction and as such may play a role in the PF abnormalities and symptoms of congestion commonly observed in HF patients.
Respiratory Physiology and Neurobiology
Copyright 2011 Elsevier B.V. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.