title: The resistance-compliance product of the pulmonary circulation varies in health and pulmonary vascular disease.
abstract: Pulmonary vascular resistance (PVR) is traditionally used to describe pulmonary hemodynamic characteristics. However, it does not take into account pulmonary artery compliance (Ca) or pulsatile flow. The product of PVR and Ca is known as RC time. Previous studies assert that the PVR-Ca relationship is fixed and RC time is constant between health and disease states. We hypothesized that RC time was not constant in health and pulmonary vascular disease. Right heart catheterizations performed in Papworth Hospital over a 6 year period were analyzed. Subjects were divided into those with normal pulmonary hemodynamics (NPH group; n = 156) and pulmonary arterial hypertension (PAH group; n = 717). RC time and the right ventricle (RV) oscillatory power fraction were calculated. RC time for the NPH group (0.47 ± 0.13 sec) is significantly lower than the PAH group (0.56 ± 0.16 sec; P < 0.0001). The RV oscillatory power fraction is lower in the NPH group (P < 0.0001). RC time correlates inversely with the RV oscillatory power fraction in each group. We conclude, there is an inverse relationship between PVR and Ca, however, this relationship is not always fixed. Consequently, RC time is significantly lower in health compared to disease with elevated pulmonary artery pressures. PAH leads to a decrease in cardiac efficiency.
authors.affiliation: Pulmonary Vascular Diseases Unit, Papworth Hospital NHS Foundation Trust, Papworth Everard Cambridge, UK.
authors.forename: Charaka
authors.initials: C
authors.lastname: Hadinnapola
authors.affiliation: MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge Biomedical Campus, Robinson Way Cambridge, UK.
authors.forename: Qiuju
authors.initials: Q
authors.lastname: Li
authors.affiliation: MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge Biomedical Campus, Robinson Way Cambridge, UK.
authors.forename: Li
authors.initials: L
authors.lastname: Su
authors.affiliation: Pulmonary Vascular Diseases Unit, Papworth Hospital NHS Foundation Trust, Papworth Everard Cambridge, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Pepke-Zaba
authors.affiliation: Pulmonary Vascular Diseases Unit, Papworth Hospital NHS Foundation Trust, Papworth Everard Cambridge, UK mark.toshner@papworth.nhs.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Toshner
keywords: Pulmonary arterial hypertension; RC time; pulmonary artery compliance