title: Analysis of V/Q-matching--a safety "biomarker" in pulmonary drug development?
abstract: Ventilation (V')/perfusion (Q') mismatch (VQM) is the single most important reason for gas-exchange abnormalities in pulmonary diseases. Pharmacological approaches can further aggravated VQM and its assessment is important to avoid hypoxemia. A theoretical framework for VQM, its relevance in clinical trials, and a stepwise evaluation approach is outlined. This assessment should entail stratification of patients- and mechanisms-at-risk for VQM. Also, its boundary conditions (e.g. cardiac output, perfusion pressure, hemoglobin concentration, changes in ventilation) need to be taken into consideration. Ultimately, VQM assessment requires invasive approaches. VQM evaluation is an important safety "biomarker" to avoid negative study outcome due to gas-exchange abnormalities.
authors.affiliation: Bayer HealthCare, Cardiology Research, Wuppertal, Germany.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Amen
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Becker
authors.forename: Hubert
authors.initials: H
authors.lastname: Truebel
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D000860:Hypoxia / Q000517:prevention & control*; D008171:Lung Diseases / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy; D011659:Pulmonary Gas Exchange; D012128:Respiratory Distress Syndrome / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000009:adverse effects; D014665:Vasodilator Agents / Q000009:adverse effects; D014692:Ventilation-Perfusion Ratio
chemical_list: D015415:Biomarkers; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D010100:Oxygen