TY - JOUR
T1 - Gas diffusion and alveolar-capillary unit in chronic heart failure
AU - Agostoni, Piergiuseppe
AU - Bussotti, Maurizio
AU - Cattadori, Gaia
AU - Margutti, Eliana
AU - Contini, Mauro
AU - Muratori, Manuela
AU - Marenzi, Giancarlo
AU - Fiorentini, Cesare
PY - 2006/11
Y1 - 2006/11
N2 - Aims: Alveolar gas diffusion (DLCO) is impaired in chronic heart failure (CHF). Diffusion depends on membrane diffusion (DM) and the amount of blood participating in gas exchange (VC). How DM, VC, and the alveolar-capillary unit behave in relationship to CHF severity is unknown. Methods and results: We measured pulmonary function, including DLCO, DM, VC, and alveolar volume (VA), in 191 CHF patients in NYHA class I-III. CHF patients were grouped accordingly to peak exercise oxygen uptake (pVO2): group 20 (n=27). DLCO, DM, VC, and VA were lowest in severe CHF and were linearly related to pV̇O 2 (DLCO, r=0.577, P20 (0.46±0.29), compared with 12-16 (0.34±0.19) and 16-20 (0.35±0.17). Conclusion: DLCO progressively worsens as CHF severity increases due to reduction in lung tissue participating to gas exchange (low VC and VA). In severe CHF, the few working alveolar-capillary units are the most efficient as shown by the high DM/VC. This is useful for maintaining gas exchange efficiency in severe CHF.
AB - Aims: Alveolar gas diffusion (DLCO) is impaired in chronic heart failure (CHF). Diffusion depends on membrane diffusion (DM) and the amount of blood participating in gas exchange (VC). How DM, VC, and the alveolar-capillary unit behave in relationship to CHF severity is unknown. Methods and results: We measured pulmonary function, including DLCO, DM, VC, and alveolar volume (VA), in 191 CHF patients in NYHA class I-III. CHF patients were grouped accordingly to peak exercise oxygen uptake (pVO2): group 20 (n=27). DLCO, DM, VC, and VA were lowest in severe CHF and were linearly related to pV̇O 2 (DLCO, r=0.577, P20 (0.46±0.29), compared with 12-16 (0.34±0.19) and 16-20 (0.35±0.17). Conclusion: DLCO progressively worsens as CHF severity increases due to reduction in lung tissue participating to gas exchange (low VC and VA). In severe CHF, the few working alveolar-capillary units are the most efficient as shown by the high DM/VC. This is useful for maintaining gas exchange efficiency in severe CHF.
KW - Exercise
KW - Heart failure
KW - Lung
KW - Oedema
KW - Ventilation
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U2 - 10.1093/eurheartj/ehl302
DO - 10.1093/eurheartj/ehl302
M3 - Article
C2 - 17028107
AN - SCOPUS:33750305115
SN - 0195-668X
VL - 27
SP - 2538
EP - 2543
JO - European Heart Journal
JF - European Heart Journal
IS - 21
ER -