Ventilatory and cardiocirculatory exercise profiles in COPD: the role of pulmonary hypertension.

Abstract:

BACKGROUND:Pulmonary hypertension (PH) is a well-recognized complication of COPD. The impact of PH on exercise tolerance is largely unknown. We evaluated and compared the circulatory and ventilatory profiles during exercise in patients with COPD without PH, with moderate PH, and with severe PH. METHODS:Forty-seven patients, GOLD (Global Initiative for Chronic Obstructive Lung Disease)stages II to IV, underwent cardiopulmonary exercise testing and right-sided heart catheterization at rest and during exercise. Patients were divided into three groups based on mean pulmonary artery pressure (mPAP) at rest: no PH (mPAP, < 25 mm Hg), moderate PH (mPAP, 25-39 mm Hg),and severe PH (mPAP, ≥ 40 mm Hg). Mixed venous oxygen saturation (S VO 2 ) was used for evaluating the circulatory reserve. Pa CO 2 and the calculated breathing reserve were used for evaluation of the ventilatory reserve. RESULTS:Patients without PH (n = 24) had an end-exercise S VO 2 of 48%± 9%, an increasing Pa CO 2 with exercise, and a breathing reserve of 22% ± 20%. Patients with moderate PH (n = 14) had an exercise S VO 2 of 40% ± 8%, an increasing Pa CO 2 , and a breathing reserve of 26% ± 15%. Patients with severe PH (n =9) had a significantly lower end-exercise S VO 2 (30% ± 6%), a breathing reserve of 37% ± 11%, and an absence of Pa CO 2 accumulation. CONCLUSION:Patients with severe PH showed an exhausted circulatory reserve at the end of exercise.A profile of circulatory reserve in combination with ventilatory impairments was found inpatients with COPD and moderate or no PH. The results suggest that pulmonary vasodilation might only improve exercise tolerance in patients with COPD and severe PH.

journal_name

Chest

journal_title

Chest

authors

Boerrigter BG,Bogaard HJ,Trip P,Groepenhoff H,Rietema H,Holverda S,Boonstra A,Postmus PE,Westerhof N,Vonk-Noordegraaf A

doi

10.1378/chest.11-2798

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

1166-1174

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(12)60618-7

journal_volume

142

pub_type

杂志文章

相关文献

CHEST文献大全
  • Treatment of the obstructive sleep apnea syndrome using a nasopharyngeal tube.

    abstract::The efficacy of a nasopharyngeal tube was evaluated in 44 patients with obstructive sleep apnea syndrome. Twenty-four of these patients underwent repeated polysomnographic studies with the nasopharyngeal tube in place. They had a 62.3 percent decrease in apnea index and a 39.2 percent decrease in disordered breathing ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.94.6.1142

    authors: Nahmias JS,Karetzky MS

    更新日期:1988-12-01 00:00:00

  • Long-term effects of nitrendipine on hemodynamics and oxygen transport in patients with cor pulmonale.

    abstract::Recent studies have suggested that vasodilators may acutely improve pulmonary hemodynamics in patients with chronic obstructive pulmonary disease and cor pulmonale, but the effects of long-term therapy have not been assessed. We evaluated the hemodynamic and gas exchange effects of nitrendipine, a calcium channel bloc...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.89.1.141

    authors: Rubin LJ,Moser K

    更新日期:1986-01-01 00:00:00

  • Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking.

    abstract:STUDY OBJECTIVE:To determine the indications for preoperative localization of a small indeterminate pulmonary nodule. DESIGN:In this retrospective study, univariate and multivariate analyses were performed by the logistic regression procedure. SETTING:A single National Cancer Center Hospital in Japan. PATIENTS:A ser...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.115.2.563

    authors: Suzuki K,Nagai K,Yoshida J,Ohmatsu H,Takahashi K,Nishimura M,Nishiwaki Y

    更新日期:1999-02-01 00:00:00

  • Sulfasalazine-induced pulmonary disease.

    abstract::We report the findings in two patients with sulfasalazine-induced pulmonary disease. The first patient developed pulmonary interstitial fibrosis after more than 4 yr of treatment for Crohn's disease. Pulmonary symptoms and chest roentgenographic and pulmonary function abnormalities gradually reversed after stopping th...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.4.1033

    authors: Hamadeh MA,Atkinson J,Smith LJ

    更新日期:1992-04-01 00:00:00

  • Paradoxical trough effects of triple therapy with budesonide/formoterol and tiotropium bromide on pulmonary function outcomes in COPD.

    abstract:BACKGROUND:Lowest receptor occupancy for a drug occurs at trough prior to the next dose. Previous studies have focused on the effects of triple therapy at peak dose intervals using forced expiratory maneuvers. Impulse oscillometry (IOS) and body plethysmography (PLETH) are more sensitive than spirometry to assess inhal...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.10-0247

    authors: Williamson PA,Short PM,Clearie KL,Vaidyanathan S,Fardon TC,Howaniec LJ,Lipworth BJ

    更新日期:2010-09-01 00:00:00

  • Pulmonary findings in patients with chagasic megaesophagus. Study of autopsied cases.

    abstract::We studied retrospectively 69 cases of chagasic megaesophagus (group 1) and 207 cases of chronic chagasic myocardiopathy (CCM) without megaesophagus (group 2) by autopsy in the Pathology Department of the Federal University of Bahia, Brazil, from 1953 to 1975. It was shown that pulmonary tuberculosis was significantly...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.83.1.87

    authors: Camara EJ,Lima JA,Oliveira GB,Machado AS

    更新日期:1983-01-01 00:00:00

  • Thrombolytic therapy of pulmonary embolism: a comprehensive review of current evidence.

    abstract::Pulmonary embolism (PE) is a common disorder that is accompanied by significant morbidity and mortality. Although anticoagulation is the standard treatment for PE, thrombolytic therapy, with its ability to produce rapid clot lysis, has long been considered an attractive alternative. Although many studies have been per...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.115.6.1695

    authors: Arcasoy SM,Kreit JW

    更新日期:1999-06-01 00:00:00

  • Peak expiratory flow with or without a brief postinspiratory pause.

    abstract:BACKGROUND:The duration of postinspiratory pause prior to forced expiration may significantly influence the peak expiratory flow (PEF) measured during maximal forceful expirations. In comparison with maneuvers without a postinspiratory pause, maneuvers with 4 to 6-s pause at total lung capacity (TLC) result in decrease...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.1.442

    authors: Omar T,Alawadhi H,Soubani AO,Tzelepis GE

    更新日期:2005-07-01 00:00:00

  • Percutaneous multiple-site parietal pleural biopsy: description and evaluation of a new and safe technique.

    abstract:STUDY OBJECTIVES:(1) To describe a new percutaneous pleural biopsy technique to obtain multiple-site parietal pleural biopsy specimens in patients with pleural effusion (PE), and (2) to evaluate its effectiveness and safety compared to current techniques. DESIGN:Prospective interventional study. SETTING:University te...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.125.5.1776

    authors: Uthaman B,Behbehani N,Abal A,Madda J,Khan S

    更新日期:2004-05-01 00:00:00

  • Myopathy following mechanical ventilation for acute severe asthma: the role of muscle relaxants and corticosteroids.

    abstract:BACKGROUND:Acute myopathy following mechanical ventilation for near-fatal asthma (NFA) has been described recently, and some researchers have suggested that this complication is related to the use of neuromuscular blocking agents (NMBAs) and corticosteroids (CSs). OBJECTIVES:To determine the incidence of acute myopath...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1378/chest.115.6.1627

    authors: Behbehani NA,Al-Mane F,D'yachkova Y,Paré P,FitzGerald JM

    更新日期:1999-06-01 00:00:00

  • Effects of bacterial infection on airway antimicrobial peptides and proteins in COPD.

    abstract:BACKGROUND:Pathogenic bacteria colonize the airways of 30% to 40% of patients with COPD and cause approximately 50% of exacerbations. New strains of nontypeable Haemophilus influenzae (NTHI) and Moraxella catarrhalis are associated with exacerbations. Antimicrobial protein/peptides (AMPs) play important roles in innate...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-2760

    authors: Parameswaran GI,Sethi S,Murphy TF

    更新日期:2011-09-01 00:00:00

  • Alive in the Airways: Live Endobronchial Foreign Bodies.

    abstract::Aspiration of a foreign body into the lower airways is a common occurrence and can cause significant morbidity and mortality in humans. Most foreign bodies of the tracheobronchial tree are inanimate. However, the medical literature includes reports of live foreign bodies in the airways. Fish, leeches, and roundworms a...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2016.10.041

    authors: Ali SR,Mehta AC

    更新日期:2017-02-01 00:00:00

  • Aortic calcification on plain chest radiography increases risk for coronary artery disease.

    abstract:STUDY OBJECTIVES:To determine whether an association exists between aortic calcification viewed on plain chest radiography and coronary artery disease. METHODS:Retrospective review of all chest radiographs obtained from consecutive patients undergoing coronary angiography at a primary cardiac center during 1999. Plain...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.121.5.1468

    authors: Li J,Galvin HK,Johnson SC,Langston CS,Sclamberg J,Preston CA

    更新日期:2002-05-01 00:00:00

  • The effects of cocaine and heroin use on intubation rates and hospital utilization in patients with acute asthma exacerbations.

    abstract:BACKGROUND:The use of both heroin and cocaine has been associated with asthma exacerbations. However, the magnitude of this effect has not been adequately described. The purpose of this study was to examine the association between cocaine or heroin use and asthma severity. METHODS:We conducted a retrospective chart re...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.4.1951

    authors: Levine M,Iliescu ME,Margellos-Anast H,Estarziau M,Ansell DA

    更新日期:2005-10-01 00:00:00

  • Purulent pericarditis with tamponade in a postpartum patient due to group F streptococcus.

    abstract::Bacterial pericarditis with cardiac tamponade is a life-threatening disorder that has been associated with a variety of organisms. There is usually an associated underlying condition or a seeding of the pericardium from an infection elsewhere. We report the development of cardiac tamponade and a subsequent pericardial...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.115.6.1746

    authors: Snyder RW,Braun TI

    更新日期:1999-06-01 00:00:00

  • Short- and long-term hemodynamic effects of captopril in patients with pulmonary hypertension and selected connective tissue disease.

    abstract::To assess the pulmonary and systemic hemodynamic effects of oral captopril in patients with connective tissue disease and pulmonary hypertension, we performed right heart catheterization in eight patients with diffuse systemic sclerosis, the CREST syndrome, or mixed connective tissue diseases prior to and immediately ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.5.1407

    authors: Alpert MA,Pressly TA,Mukerji V,Lambert CR,Mukerji B

    更新日期:1992-11-01 00:00:00

  • The effect of montelukast and low-dose theophylline on cardiovascular disease risk factors in asthmatics.

    abstract:BACKGROUND:Recent studies have implicated the 5-lipoxygenase/leukotriene (LT) pathway in cardiovascular disease (CVD), which may have important implications for asthmatics because several drugs that target this pathway are currently used to treat asthma. We sought to determine whether montelukast, a cysteinyl LT antago...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.07-0831

    authors: Allayee H,Hartiala J,Lee W,Mehrabian M,Irvin CG,Conti DV,Lima JJ

    更新日期:2007-09-01 00:00:00

  • Is pH paper an acceptable, low-cost alternative to the blood gas analyzer for determining pleural fluid pH?

    abstract:BACKGROUND:Our laboratory uses pH paper rather than a blood gas analyzer to measure pleural fluid pH to decrease cost and avoid analyzer malfunction due to viscous fluids. METHODS:To compare these two methods of determining pleural fluid pH, 42 patients undergoing diagnostic or therapeutic thoracentesis had two 1-mL a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.112.5.1291

    authors: Lesho EP,Roth BJ

    更新日期:1997-11-05 00:00:00

  • Positive end-expiratory pressure vs T-piece. Extubation after mechanical ventilation.

    abstract::Because T-piece breathing may impair oxygenation, the best airway pressure from which to extubate ventilated patients is controversial. We compared the effects of extubation after 1 h of either CPAP 5 and T-piece/ZEEP. Once weaned from mechanical ventilation and breathing spontaneously, 106 patients were randomized to...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.100.6.1655

    authors: Jones DP,Byrne P,Morgan C,Fraser I,Hyland R

    更新日期:1991-12-01 00:00:00

  • Video-assisted contralateral treatment for bronchial stump diastasis after left pneumonectomy.

    abstract::Postoperative bronchial stump failure is a life-threatening complication, and several surgical approaches and procedures have been developed to close the stump. In this report, we describe a case of left mainstem bronchial stump diastasis after pneumonectomy for lung cancer, in which the bronchial stump was re-closed ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.117.3.884

    authors: Tsunezuka Y,Sato H,Kodama T

    更新日期:2000-03-01 00:00:00

  • Left atrial myxoma and acute myocardial infarction. A dangerous duo in the thrombolytic agent era.

    abstract::Systemic embolization is a common complication of left atrial myxoma; however, coronary embolism leading to acute myocardial infarction is rare. The use of echocardiography has increased the detection of intracardiac tumors when signs and symptoms are not evident. Echocardiography is the diagnostic procedure of choice...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.109.4.1106

    authors: Abascal VM,Kasznica J,Aldea G,Davidoff R

    更新日期:1996-04-01 00:00:00

  • Multicentric endobronchial granular cell myoblastoma.

    abstract::Granular cell myoblastoma (GCM) is a rare benign neoplasm involving the tracheobronchial tree. It is believed to arise from the Schwann cell. Four cases of tracheobronchial GCM, all of which were multicentric, are presented and a conservative therapeutic approach is suggested. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.4.945

    authors: Redjaee B,Rohatgi PK,Herman MA

    更新日期:1990-10-01 00:00:00

  • Primary pulmonary hypertension in a patient with CD8/T-cell large granulocyte leukemia: amelioration by cladribine therapy.

    abstract::We report a case of primary pulmonary hypertension in an adult man with CD8/T-cell large granulocyte leukemia. Successful treatment of his leukemia with cladribine resulted in dramatic and sustained improvement of his pulmonary hypertension. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.112.2.551

    authors: Rossoff LJ,Genovese J,Coleman M,Dantzker DR

    更新日期:1997-08-01 00:00:00

  • Increasing doses of inhaled corticosteroids compared to adding long-acting inhaled beta2-agonists in achieving asthma control.

    abstract:BACKGROUND:Combination therapy with inhaled corticosteroids (ICSs) and long-acting beta(2)-agonists (LABAs), or treatment with high doses of ICSs alone improves asthma control when therapy with low-dose ICSs is not sufficient. However, it is not known which of these treatment options is more effective in sustaining ast...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.08-1018

    authors: O'Byrne PM,Naya IP,Kallen A,Postma DS,Barnes PJ

    更新日期:2008-12-01 00:00:00

  • Treatment of warfarin-associated coagulopathy: a physician survey.

    abstract:STUDY OBJECTIVES:(1) To determine physician preferences in the management of warfarin-induced excessive anticoagulation (AC); and (2) to assess compliance with the American College of Chest Physicians (ACCP) guidelines for the reversal of excessive AC. DESIGN:Cross-sectional physician survey. PARTICIPANTS:Members of ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.120.6.1972

    authors: Wilson SE,Douketis JD,Crowther MA

    更新日期:2001-12-01 00:00:00

  • Maximal exercise testing for the selection of heart transplantation candidates: limitation of peak oxygen consumption.

    abstract:BACKGROUND:Peak exercise oxygen consumption (peak VO2), which is considered an indicator of prognosis in advanced heart failure, is currently being used as a major criterion in many centers for the selection of candidates for heart transplantation. Available studies suggest that patients with peak VO2 < 14 mL/min/kg ha...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.115.2.410

    authors: Ramos-Barbón D,Fitchett D,Gibbons WJ,Latter DA,Levy RD

    更新日期:1999-02-01 00:00:00

  • Colloid osmotic pressure in infants with hyaline membrane disease.

    abstract::Colloid osmotic pressure (COP) was measured serially in 81 critically ill neonates with hyaline membrane disease (HMD) during the first five days of life, and these changes were correlated with the birth weight, gestational age, serum protein level, clinical status, and outcome. Colloid osmotic pressure correlated bet...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.83.5.776

    authors: Bhat R,Malalis L,Shukla A,Vidyasagar D

    更新日期:1983-05-01 00:00:00

  • Captopril lowers coronary venous free radical concentration after direct current cardiac shocks.

    abstract:STUDY OBJECTIVES:Direct current (DC) shocks to the heart cause morphologic and functional myocardial damage. Previous studies have suggested that acute DC shock injury is free radical mediated and that the administration of antioxidant enzymes superoxide dismutase and catalase can reduce the level of DC shock-induced f...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.116.2.484

    authors: Pagan-Carlo LA,Garcia LA,Hutchison JL,Buettner GR,Kerber RE

    更新日期:1999-08-01 00:00:00

  • Orbital herniation associated with noninvasive positive pressure ventilation.

    abstract::A diagnosis of severe obstructive sleep apnea was made after a 52-year-old hypertensive man developed a large intracranial hemorrhage. Therapeutic noninvasive positive pressure ventilation (NPPV) for obstructive sleep apnea and hypoventilation was complicated by transient unilateral orbital herniation. As best as can ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.113.3.841

    authors: Lazowick D,Meyer TJ,Pressman M,Peterson D

    更新日期:1998-03-01 00:00:00

  • Efficacy of inhaled metaproterenol and orally-administered theophylline in patients with chronic airflow obstruction.

    abstract::To evaluate comparative bronchodilator efficacy with chronic airflow obstruction (CAO), we randomly administered to ten patients week-long treatments consisting of: inhaled metaproterenol from a metered dose canister (1.30 mg six times a day) and doses of a sustained-release theophylline formulation sufficient to achi...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.89.2.171

    authors: Dullinger D,Kronenberg R,Niewoehner DE

    更新日期:1986-02-01 00:00:00