Skip Navigation


European Heart Journal Advance Access originally published online on October 6, 2006
European Heart Journal 2006 27(21):2538-2543; doi:10.1093/eurheartj/ehl302
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
27/21/2538    most recent
ehl302v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Agostoni, P.
Right arrow Articles by Fiorentini, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Agostoni, P.
Right arrow Articles by Fiorentini, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Gas diffusion and alveolar–capillary unit in chronic heart failure

Piergiuseppe Agostoni1,2,*, Maurizio Bussotti1, Gaia Cattadori1, Eliana Margutti3, Mauro Contini1, Manuela Muratori1, Giancarlo Marenzi1 and Cesare Fiorentini1

1 Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, via Parea 4, 20138 Milan, Italy
2 Division of Respiratory and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA 98185, USA
3 Istituto di Medicina Interna, University of Milan, Milan, Italy

Received 3 May 2006; revised 14 September 2006; accepted 21 September 2006; online publish-ahead-of-print 6 October 2006.

* Corresponding author. Tel: +39 02 58002299; fax: +39 02 58011039. E-mail address: piergiuseppe.agostoni{at}ccfm.it

Aims Alveolar gas diffusion (DLCO) is impaired in chronic heart failure (CHF). Diffusion depends on membrane diffusion (DM) and the amount of blood participating in gas exchange (VC). How DM, VC, and the alveolar–capillary unit behave in relationship to CHF severity is unknown.

Methods and results We measured pulmonary function, including DLCO, DM, VC, and alveolar volume (VA), in 191 CHF patients in NYHA class I–III. CHF patients were grouped accordingly to peak exercise oxygen uptake (pVO2): group <12 mL/min/kg (n=24), group 12–16 (n=76), group 16–20 (n=64), and group >20 (n=27). DLCO, DM, VC, and VA were lowest in severe CHF and were linearly related to pVO2 (DLCO, r=0.577, P<0.001; DM, r=0.490, P<0.001; VC, r=0.216, P<0.01; VA, r=0.565, P<0.01). DM/VC ratio, an index of the alveolar–capillary unit efficiency, was higher in group <12 (0.49±0.39 mL/min/mmHg/mL) and >20 (0.46±0.29), compared with 12–16 (0.34±0.19) and 16–20 (0.35±0.17).

Conclusion DLCO progressively worsens as CHF severity increases due to reduction in lung tissue participating to gas exchange (low VC and VA). In severe CHF, the few working alveolar–capillary units are the most efficient as shown by the high DM/VC. This is useful for maintaining gas exchange efficiency in severe CHF.

Key Words: Heart failure • Exercise • Lung • Oedema • Ventilation


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 ChestHome page
I. Szollosi, B. R. Thompson, H. Krum, D. M. Kaye, and M. T. Naughton
Impaired Pulmonary Diffusing Capacity and Hypoxia in Heart Failure Correlates With Central Sleep Apnea Severity
Chest, July 1, 2008; 134(1): 67 - 72.
[Abstract] [Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.