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Meyer, FJ; Ewert, R; Hoeper, MM; Olschewski, H; Behr, J; Winkler, J; Wilkens, H; Breuer, C; Kübler, W; Borst, MM; German PPH Study Group.
Peripheral airway obstruction in primary pulmonary hypertension.
Thorax. 2002; 57(6):473-476 Doi: 10.1136/thorax.57.6.473 [OPEN ACCESS]
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Olschewski Horst
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Abstract:
BACKGROUND: As there is controversy about changes in lung function in primary pulmonary hypertension (PPH), lung mechanics were assessed with a focus on expiratory airflow in relation to pulmonary haemodynamics. METHODS: A cross sectional study was performed in 64 controls and 171 patients with PPH (117 women) of mean (SD) age 45 (13) years, pulmonary artery pressure (PAPmean) 57 (15) mm Hg, and pulmonary vascular resistance 1371 (644) dyne.s/cm(5). RESULTS: Mean (SD) total lung capacity was similar in patients with PPH and controls (98 (12)% predicted v 102 (17)% predicted, mean difference -4 (95% confidence interval (CI) -7.89 to -0.11); residual volume (RV) was increased (118 (24)% predicted v 109 (27)% predicted, mean difference 9 (95% CI 1.86 to 16.14); and vital capacity (VC) was decreased (91 (16)% predicted v 102 (10)% predicted, mean difference -11 (95% CI 15.19 to -6.80). RV/TLC was increased (117 (27)% predicted v 97 (29)% predicted, mean difference 20 (95% CI 12.3 to 27.8)) and correlated with PAPmean (r=0.31, p<0.001). In patients with PAPmean above the median of 56 mm Hg, RV/TLC was further increased (125 (32)% predicted v 111 (22)% predicted, mean difference -14 (95% CI -22.2 to -5.8)). Expiratory flow-volume curves were reduced and curvilinear in patients with PPH. CONCLUSIONS: Peripheral airway obstruction is common in PPH and is more pronounced in severe disease. This may contribute to symptoms. Reversibility of bronchodilation and relation to exercise capacity need further evaluation.
Find related publications in this database (using NLM MeSH Indexing)
Airway Obstruction - complications
Cohort Studies - complications
Cross-Sectional Studies - complications
Female - complications
Forced Expiratory Volume - physiology
Hemodynamic Processes - physiology
Humans - physiology
Hypertension, Pulmonary - complications
Male - complications
Maximal Expiratory Flow Rate - physiology
Middle Aged - physiology
Respiratory Mechanics - physiology
Total Lung Capacity - physiology
Vital Capacity - physiology

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