Relationship between bronchial hyperreactivity and symptoms of cardiac asthma in patients with non-valvular left ventricular failure.
To determine whether a relationship exists between bronchial hyperreactivity and cardiac asthma, which is commonly observed in patients with left heart failure, a methacholine inhalation test was performed in 15 patients with stable left ventricular failure (LVF) and 10 normal subjects. The subjects were divided into 3 groups based on symptoms of nocturnal coughing and/or wheezing in acute exacerbation of LVF. Group A consisted of 8 patients with nocturnal coughing and/or wheezing. Group B consisted of 7 patients without such symptoms, and Group C consisted of the 10 age-matched normal controls. Eleven of the 15 patients with LVF showed a significant increase in respiratory resistance in the methacholine inhalation test, as opposed to none of the normal subjects. The median cumulative dose which produced a 35% decrease in respiratory conductance (PD35Grs) was significantly lower in Group A than in Group B (1.45 log units and 1.90 log units, respectively, p < 0.05). The results of pulmonary function tests were not significantly different between Groups A and B. The minimum cumulative dose required to initiate a decrease in respiratory conductance from the baseline, as an index of bronchial sensitivity to methacholine, was significantly correlated with DLCO/VA (r = 0.710, p < 0.01). We conclude that bronchial hyperreactivity is responsible for cardiac asthma and that it might be related to pulmonary interstitial changes in stable patients with non-valvular LVF.
Nishimura
Y
Y
First Department of Internal Medicine, Kobe University School of Medicine, Japan.
Maeda
H
H
Hashimoto
A
A
Tanaka
K
K
Yokoyama
M
M
D000328:Adult; D016535:Bronchial Hyperreactivity / Q000150:complications*; D003371:Cough; D004418:Dyspnea, Paroxysmal / Q000150:complications*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D018487:Ventricular Dysfunction, Left / Q000150:complications*
D016210:Methacholine Chloride