Systemic to pulmonary bronchial blood flow in heart failure.
OBJECTIVE
The aim of this study was to measure systemic to pulmonary blood flow from bronchial circulation (Qbr[s-p]) in patients with heart failure.


METHODS
In the absence of pulmonary and coronary flows, Qbr(s-p) is the volume of blood accumulating in the left side of the heart; Qbr(s-p) was measured during total cardiopulmonary bypass for coronary artery surgery; bronchial blood was vented through a cannula introduced into the left side of the heart and its volume was measured.


METHODS
Patients were subdivided according to the presence for more than 6 months (group 1, n = 6) or less than 2 months (group 2, n = 7), or the absence of heart failure (group 2, n = 15).


RESULTS
Qbr(s-p) was 89 +/- 18* mL/min, 27 +/- 3, 22 +/- 2, in groups 1, 2, and 3, respectively (* = p < 0.01 group 1 vs groups 2 and 3). During total cardiopulmonary bypass, pulmonary venous pressure approximates atmospheric pressure and no differences between groups were observed in systemic artery pressure, extracorporeal circulation pump flow, and airway pressure. Therefore, vascular resistance through the bronchial vessels draining into the pulmonary circulation is reduced in patients with heart failure for more than 6 months (group 1).


CONCLUSIONS
During total cardiopulmonary bypass, Qbr(s-p) is increased in patients with chronic heart failure. Since with elevated pulmonary vascular pressure blood flow through Qbr(s-p) vessels is from the pulmonary to the systemic circulation, the lower resistance observed in group 1 suggests that bronchial vessels might contribute to reduced lung fluid overload in patients with chronic heart failure.
Agostoni
P G
PG
Istituto di Cardiologia dell' Università degli Studi di Milano, Italy.
Doria
E
E
Bortone
F
F
Antona
C
C
Moruzzi
P
P
D000328:Adult; D000368:Aged; D001775:Blood Circulation; D001980:Bronchi / Q000098:blood supply*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation