title: Detection of inspiratory resistive loads by heart-lung transplant recipients.
abstract: Human heart-lung transplantation recipients (HL) are models for the effects of selective lower respiratory tract denervation. We used a series resistor to examine thresholds of inspiratory flow resistance perception among 16 HL in comparison with 15 normal control subjects (C) and 12 heart transplant recipients (H). HL and C were closely age matched. H subjects were older and had mildly reduced lung volumes compared with the other groups. The perception threshold was defined as the added resistance (delta R) detected by subjects at 50% of random, blinded presentations. These delta R were subsequently expressed as a fraction of the airway resistance of the subject and baseline resistance of the apparatus (delta R/Raw + Rapparatus), otherwise known as the Weber fraction. The mean +/- SEM Weber fractions were nearly identical for HL and C (0.32 +/- 0.05 versus 0.34 +/- 0.05, respectively). The Weber fraction of H (0.74 +/- 0.17) was significantly greater than those of both other groups (p less than 0.05 by Kruskal-Wallis test). We conclude that lower respiratory tract afferents do not play a significant role in the perception of inspiratory resistive loads. The finding of an abnormally high Weber fraction in the heart transplant population remains unexplained but may be a function of age or restrictive pulmonary defects.
authors.affiliation: Division of Respiratory Medicine, Stanford University Medical Center, California.
authors.forename: D P
authors.initials: DP
authors.lastname: Tapper
authors.forename: S R
authors.initials: SR
authors.lastname: Duncan
authors.forename: S
authors.initials: S
authors.lastname: Kraft
authors.forename: F T
authors.initials: FT
authors.lastname: Kagawa
authors.forename: S
authors.initials: S
authors.lastname: Marshall
authors.forename: J
authors.initials: J
authors.lastname: Theodore
mesh_terms: D000328:Adult; D000403:Airway Resistance; D005260:Female; D016041:Heart-Lung Transplantation; D006801:Humans; D008297:Male; D010465:Perception; D012123:Pulmonary Ventilation; D012137:Respiratory System / Q000294:innervation; D012684:Sensory Thresholds