Interpretation of high wedge pressure on exercise in patients with chronic obstructive pulmonary disease.

In a retrospective review of patients subjected to right heart catheterization, case records from 109 consecutive patients with chronic obstructive pulmonary disease (COPD) and wedge pressure > or =15 mm Hg on exercise were analyzed. Patients were separated into group 1, resting wedge pressure (P macro w) <15 mm Hg and difference between P macro w and right atrial pressure (P macro ra) change on exercise <5 mm Hg (n = 54), group 2, same P macro w at rest but increase in macro on exercise > or =5 mm Hg, being higher than that of P macro ra (n = 34), and group 3, P macro w > or =15 mm Hg at rest (n = 21). The occurrence of left heart disease increased from group 1 to group 3 (19, 53 and 71%, respectively), and the slope of the P macro w/stroke index relationship was lowest in group 3.

Inter- and intrasubject variability of the thermodilution measurement of right ventricular ejection fraction and volume in patients with chronic obstructive pulmonary disease.

Study Objective: To determine the spontaneous changes in volumetric indices of right ventricular function assessed by thermodilution.

Design: The study involved measurements of inter- and intraindividual variation of right ventricular function in human subjects at rest and at two different levels of low load supine bicycle exercise.

Subjects: The subjects were 23 patients with chronic obstructive pulmonary disease, referred for evaluation by right heart catheterisation.

Maximal oxygen consumption and pulmonary circulation in patients with chronic bronchitis.

In order to study the relations between maximal oxygen consumption during exercise (VO2max) and the pulmonary circulation when pulmonary artery pressure (PPA) and pulmonary vascular resistance (PVR) are normal or close to normal, we evaluated twenty-three patients with chronic bronchitis, in stable clinical condition. All these patients performed a progressive exercise test on a bicycle ergometer until exhaustion (VO2max); they were also subjected to right heart catheterization at rest and during light exercise at constant load. In these patients with moderate functional impairment, we observed on average a significant, although weak, correlation (r = -0.

Oxygen consumption and transport in stable patients with chronic obstructive pulmonary disease.

We studied the relationship between oxygen consumption and systemic oxygen transport in 30 clinically stable patients with chronic obstructive pulmonary disease (COPD) before and after increasing oxygen transport by passive leg elevation to raise the cardiac output. Results were compared with those observed in 10 patients with silicosis. The effect of leg elevation on oxygen consumption was also studied in 12 normal subjects.

Pulmonary and systemic hemodynamic evolution in chronic bronchitis.

Hemodynamic values obtained during right heart catheterization in about 35 patients with chronic bronchitis were compared with the same variables 3.3 years later (range, 2 to 5 years). In the group of 13 patients with mean pulmonary arterial pressure less than 20 mm Hg at the first catheterization, the average value was 15.