Bronchial hyperreactivity in patients with moderate pulmonary circulation overload
| Autor: | Kristof Graf, Gert Kunkel, Tilo Brunnée, Eckart Fleck, Birgit Kastens |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Cardiac Catheterization Pulmonary Circulation Coronary Disease Critical Care and Intensive Care Medicine Bronchial Provocation Tests Pulmonary function testing Airway resistance Internal medicine Forced Expiratory Volume medicine Humans Mitral Valve Stenosis Respiratory function Aged Heart Failure Ejection fraction Lung business.industry Airway Resistance respiratory system Middle Aged medicine.disease Acetylcholine respiratory tract diseases medicine.anatomical_structure Bronchial hyperresponsiveness Heart failure Anesthesia Heart catheterization Cardiology Female Bronchial Hyperreactivity Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 103(5) |
| ISSN: | 0012-3692 |
| Popis: | The clinical course of congestive heart failure (CHF) and mitral valve stenosis (MVS) is accompanied by episodes of dyspnea, wheezing, and cough, symptoms also observed in patients with bronchial hyperreactivity. However, it is still controversial whether bronchial hyperreactivity is demonstrable in patients with chronic overload of the pulmonary circulation. In order to examine the effects of CHF on the respiratory function, we performed pulmonary function tests, titrated bronchial acetylcholine provocations, and left and right heart catheterization in 21 patients with impaired left ventricular function (mean ejection fraction, 37 percent, NYHA class 3), 5 patients with MVS, and 17 control patients with coronary artery disease (mean ejection fraction, 63 percent). Bronchial hyperresponsiveness was defined as an obstructive response to increased doses of inhaled acetylcholine. A 20 percent fall in forced expiratory volume in the first second (FEV1), a 100 percent increase in total airway resistance (Rtot), and a 60 percent reduction of pulmonary conductance (SGtot) were considered positive. Patients with impaired left ventricular function showed significantly higher airway resistance, and lower airway conductance at the maximal tolerated acetylcholine dose compared with control patients. Patients with MVS had a significant lower airway conductance. The induced bronchial obstruction was completely reversible upon inhalation of a beta 2-mimetic. We conclude that chronic overload of the pulmonary circulation is accompanied by bronchial hyperreactivity that may augment the symptoms of dyspnea in patients with CHF and MVS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|