[The repercussions of pulmonary congestion on ventilatory volumes, capacities and flows].
OBJECTIVE
To evaluate the effects of pulmonary congestion on pulmonary function.


METHODS
Prospective study performed in patients with left ventricular failure or mitral stenosis.


METHODS
Forty-eight hospitalized patients were included suffering from pulmonary congestion either from left ventricular failure or mitral stenosis. While in hospital all patients were submitted to right heart catheterization by the Swan-Ganz method and also to an echocardiographic examination. Within 48 hours after the patients were submitted to the following lung function studies: lung volumes and capacities by the multi-breath helium dilution method and airway flows by pneumotachography. Respiratory symptoms were evaluated by the Medical Research Council Questionnaire and the functional class classified according to the NYHA. Correlations were made between the functional and clinical data.


RESULTS
Regarding the cardiac evaluation patients presented with a mean pulmonary wedge pressure of 19.9 +/- 8.6 mmHg, a cardiac index of 2.5 +/- 0.8 l/min/m2, an end diastolic dimension of the left ventricle of 65.9 +/- 10.1 mm, and end systolic dimension of 51.2 +/- 12.2 mm, with a shortening fraction of 21.8 +/- 9.5%. The pulmonary evaluation showed a restrictive syndrome with a reduction in the mean values of the following parameters: total pulmonary capacity 71 +/- 14.4% of the predicted value (pv), forced vital capacity (FVC) 69.8 +/- 20.5% pv, and forced expiratory volume (FEV1) of 64 +/- 21.8% vp. The index FEV1/FVC was within the normal value of 72.7 +/- 9.7%. These lung function results did not correlate significantly with either the clinical, the hemodynamic or echocardiographic findings.


CONCLUSIONS
In these group of patients pulmonary congestion led to the development of a restrictive syndrome which failed to correlate in severity with the duration of the disease, the pulmonary wedge pressure and the left ventricular function.
Hospital Pulido Valente (HPV).
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Rendas
D000368:Aged; D002407:Catheterization, Swan-Ganz; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000503:physiopathology; D011446:Prospective Studies; D011660:Pulmonary Heart Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012123:Pulmonary Ventilation; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology
Repercussões da estase pulmonar sobre volumes, capacidades e débitos ventilatórios.