title: Hemodynamic characterization of patients with severe emphysema.
abstract: In 120 patients with severe emphysema evaluated for participation in the National Emphysema Treatment Trial, pulmonary hemodynamics and ventricular function were assessed. Pulmonary function tests were (%predicted): FEV(1) = 27%; residual volume = 224.6%; diffusion capacity = 26.7%. In 90.8% of patients, end-expiratory pulmonary artery mean pressure was > 20 mm Hg; in 61.4%, end-expiratory wedge pressure was > 12 mm Hg. Cardiac index was normal. Mean pulmonary artery pressure correlated inversely with arterial PO(2), and severity of emphysema, and directly with wedge pressure. Multiple stepwise regression revealed that arterial PO(2) was not an independent predictor of mean pulmonary artery pressure. No correlation was found between indices of emphysema severity and PA pressures. Diastolic ventricular pressures were increased without evidence of systolic dysfunction. We conclude that (1) elevations of pulmonary vascular pressures are common, (2) pulmonary hypertension may be related to factors other than hypoxia, (3) pulmonary hypertension does not impair resting systemic O(2) delivery, and (4) elevated cardiac diastolic pressures do not represent systolic dysfunction.
authors.affiliation: Pulmonary and Critical Care Divisions, Long Island Jewish Medical Center, Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, NY, USA. sscharf@medicine.umaryland.edu
authors.forename: Steven M
authors.initials: SM
authors.lastname: Scharf
authors.forename: Mobeen
authors.initials: M
authors.lastname: Iqbal
authors.forename: Cesar
authors.initials: C
authors.lastname: Keller
authors.forename: Gerald
authors.initials: G
authors.lastname: Criner
authors.forename: Shing
authors.initials: S
authors.lastname: Lee
authors.forename: Henry E
authors.initials: HE
authors.lastname: Fessler
mesh_terms: D000368:Aged; D002302:Cardiac Output / Q000502:physiology; D004646:Emphysema / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology*; D000860:Hypoxia / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012146:Rest / Q000502:physiology; D012720:Severity of Illness Index; D016276:Ventricular Function / Q000502:physiology