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6. Interpretation of High Wedge Pressure on Exercise in Patients with Chronic Obstructive Pulmonary Disease.

Author

Schrijen, Francine, Poincelot, Fran¸oise, Polu, Jean-Marie, and Chabot, Fran¸ois

Subjects
CARDIAC catheterization, OBSTRUCTIVE lung diseases, EXERCISE tests, BLOOD pressure, HEART diseases, HEART failure, LEFT heart ventricle
Abstract

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 ≥15 mm Hg on exercise were analyzed. Patients were separated into group 1, resting wedge pressure (&Pmacr;w) <15 mm Hg and difference between &Pmacr;w and right atrial pressure (&Pmacr;ra) change on exercise <5 mm Hg (n = 54), group 2, same &Pmacr;w at rest but increase in &Pmacr;w on exercise ≥5 mm Hg, being higher than that of &Pmacr;ra (n = 34), and group 3, &Pmacr;w ≥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 &Pmacr;w/stroke index relationship was lowest in group 3. High &Pmacr;w on exercise can be explained by the pressure rise in the cardiac fossa associated with lower lobe gas trapping in group 1, which showed the most severe airflow limitation, decreased left ventricular compliance in group 2, and heart failure in group 3.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2001
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