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Right ventricular function in patients with chronic obstructive pulmonary disease

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Summary

Simultaneous right heart catheterization and radionuclide ventriculography were performed in 27 patients with a wide range of chronic obstructive pulmonary disease. Central hemodynamics and radionuclide studies were done at rest and during exercise. In the resting state the right ventricular ejection fraction (RVEF) was in the normal range (43.3±6%). During exercise a significant (p<0.001) decrease of RVEF to 38.8±6.7% occurred. The pumonary artery mean pressures were 19.9±3.8 at rest. During exercise a significant (p<0.001) increase to 41±9.8 mm Hg occurred. There was a linear relationship between pulmonary pressures and RVEF during exercise in patients with pulmonary artery pressures not exceeding 35 mm Hg. In patients with right ventricular end-diastolic wall thickness ≧6 mm a curvilinear relationship between these parameters could be observed with a flattening of the curve at higher pressures (>35 mm Hg) and lower ejection fractions (<35% RVEF). Radionuclide venticulography cannot substitute for right heart catheterization. Echocardiography is useful for interpretation of right ventricular ejection fractions in advanced chronic obstructive pulmonary disease.

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Abbreviations

CI:

Cardiac index (l/min/m2)

CO:

Cardiac output (l/min)

COPD:

Chronic obstructive pulmonary disease

FEV1 :

Forced expiratory volume in the first second (ml)

HR:

Heart rate (B/min)

PAd:

Pulmonary artery diastolic pressure (mm Hg)

PAP:

Pulmonary artery mean pressure (mm Hg)

PAs:

Pulmonary artery peak pressure (mm Hg)

PVR:

Pulmonary vascular resistance (dyn·s·cm−5)

PwP:

Pulmonary capillary wedge pressure (mm Hg)

RAP:

Right arterial pressure (mm Hg)

Raw:

Airway resistance (cm H2/l/s)

RNV:

Radionuclide ventriculogram

RV:

Residual volume (l)

RVEF:

Right ventricular ejection fraction (%)

RVEDVI:

Right ventricular enddiastolic volume index (ml/m2)

RVEDVI:

SVI RVEF (ml/m2)

RVESVI:

Right ventricular endsystolic index (m2/m2)

SVI:

Stroke volume index (ml/m2)

TLC:

Total lung capacity (l)

VC:

Vital capacity (l)

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Authors and Affiliations

  1. Sektion Kardiologie, Pulmonologie, Angiologie, Universität Ulm, Germany

    H. Seibold, J. Kohler & A. Schmidt

  2. Abteilung Nuklearmedizin, Universität Ulm, Germany

    E. Henze, J. Roth & W. Adam

Authors
  1. H. Seibold
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  2. E. Henze
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  3. J. Kohler
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  4. J. Roth
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  5. A. Schmidt
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  6. W. Adam
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Seibold, H., Henze, E., Kohler, J. et al. Right ventricular function in patients with chronic obstructive pulmonary disease. Klin Wochenschr 63, 1041–1047 (1985). https://doi.org/10.1007/BF01739670

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  • DOI: https://doi.org/10.1007/BF01739670

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