[Impact of the deep breathing maneuver in the gas exchange in the subject with severe obesity and pulmonary arterial hypertension associated to Eisenmenger's syndrome].
Obesity and Eisenmenger's syndrome are entities widely studied. However, its association is unusual and has not been reported. A wide range of gas exchange abnormalities have been describe in both groups. In the severe obese patients this abnormalities are attributed to a ventilation/perfusion mismatch and to an increase pulmonary venous-arterial shunt, that correlates with the lung volume. In severe obese patients with the Eisenmenger's syndrome, this correlation is unknown.


METHODS
We studied 28 obese subjects paired by body mass index > 30 kg/m2. Assigned to two groups, obese with Eisenmenger's syndrome and obese without the syndrome. Clinical variables, respiratory function, echocardiography and gas exchange pre and post-deep breathing maneuver were obtained.


METHODS
The variables are expressed with mean+/-standard deviation. Student t test for paired groups and Pearson correlation coefficient were gathered for the differences and associations between groups. A p-value <0.05 was considered significant.


RESULTS
Age was 48.57 +/- 10.32 vs 60.86 +/- 10.47 y.o. respectively, p < 0.004. Systolic pulmonary arterial pressure 104.36 +/- 37 vs 50.1 +/- 12 mm Hg, p < 0.001. The arterial oxygen pressure at rest and during the deep breathing maneuver in each group was: 51.64 +/- 6.38 vs 57.14 +/- 11, p < 0.188 and 56.29 +/- 11.15 vs 72 +/- 11.83, p < 0.001; venous-arterial shunt 12.79 +/- 3.66 vs 13.07 +/- 4.84, p < 0.767 and 9.21 +/- 3.77 vs 6.5 +/- 2.28, p < 0.001; alveolar arterial oxygen difference 271.14 +/- 79.92 vs 243.79 +/- 92.07, p < 0.001, respectively.


CONCLUSIONS
Obese subjects with Eisenmenger's syndrome, did not have significant improvement of gas exchange with the deep breathing maneuver.
Santos-Martínez
Luis-Efren
LE
Departamento de Cardioneumologia, Instituto Nacional de Cardiologia Ignacio Chávez, Mexico, D.F. sanlui@cardiologia.org.mx
Martínez-Guerra
María-Luisa
ML
Bautista
Edgar
E
Castillo
Francisco
F
Castañón
Alicia
A
Pulido
Tomás
T
Hernández
José-Luis
JL
Sandoval
Julio
J
D004541:Eisenmenger Complex / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000378:metabolism* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange; D012119:Respiration; D012720:Severity of Illness Index