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Ventilation-perfusion relationships in pulmonary arterial hypertension: Effect of intravenous and inhaled prostacyclin treatment
Department of Clinical Physiology, Karolinska University Hospital, Huddinge.
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2007 (English)In: Respiratory Physiology & Neurobiology, ISSN 1569-9048, E-ISSN 1878-1519, Vol. 158, no 1, 59-69 p.Article in journal (Refereed) Published
Abstract [en]

In seven patients with idiopathic or secondary pulmonary arterial hypertension (PAH), ventilation-perfusion (V-A/Q) relationships were measured during a right heart catheterization using the multiple inert-gas elimination technique before and during intravenous infusion with epoprostenol (EPO), and following 5 months of 20 mu g inhaled iloprost taken three times daily (ILO). Pre-treatment pulmonary vascular resistance (PVR) was 9.3 +/- 5.0 mmHg/l/min and the dispersion of perfusion and ventilation for V-A/Q-ratios was increased. EPO reduced PVR by 20%, and increased cardiac output, shunt, and mixed venous oxygenation (Sv(O2)) The arterial oxygen tension (Pa-O2) remained unchanged. Basal central haemodynamics did not change after 5 months of ILO. Fifteen minutes after ILO, PVR decreased by 20%, and the shunt, Sv(O2), and Pa-O2 remained unaltered. Conclusions: In secondary PAH with normal lung volumes, significant V-A/Q mismatching occurred. The PVR was reduced to a similar degree during EPO and after ILO, but only EPO increased the shunt and Sv(O2). EPO and ILO did not significantly affect the Pa-O2.

Place, publisher, year, edition, pages
2007. Vol. 158, no 1, 59-69 p.
Keyword [en]
V-A/Q ratios, multiple inert-gas elimination technique, shunt, mixed venous oxygenation, pulmonary arterial hypertension, epoprostenol, inhaled iloprost, hypoxaemia, gas-exchange, nitric-oxide, continuous distributions, cardiac-output, disease, exercise, iloprost, therapy, inequality, mechanisms
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:kth:diva-16809DOI: 10.1016/j.resp.2007.03.003ISI: 000248158100010OAI: oai:DiVA.org:kth-16809DiVA: diva2:334852
Note
QC 20100525Available from: 2010-08-05 Created: 2010-08-05 Last updated: 2017-12-12Bibliographically approved

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