Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension

Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension

<p>Abstract</p> <p>Background</p> <p>Reduced gas transfer in patients with pulmonary arterial hypertension (PAH) is traditionally attributed to remodeling and progressive loss of pulmonary arterial vasculature that results in decreased capillary blood volume available f...

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Main Authors: Farha Samar, Laskowski Daniel, George Deepa, Park Margaret M, Tang WH Wilson, Dweik Raed A, Erzurum Serpil C
Format: Article
Language:English
Published: BMC 2013-01-01
Series:Respiratory Research
Subjects:
Membrane diffusion
Pulmonary arterial hypertension
Lung capillary blood volume
Online Access:http://respiratory-research.com/content/14/1/6
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spelling doaj-9f4d344f53da4793927fd9312c6791612020-11-24T21:37:57ZengBMCRespiratory Research1465-99212013-01-01141610.1186/1465-9921-14-6Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertensionFarha SamarLaskowski DanielGeorge DeepaPark Margaret MTang WH WilsonDweik Raed AErzurum Serpil C<p>Abstract</p> <p>Background</p> <p>Reduced gas transfer in patients with pulmonary arterial hypertension (PAH) is traditionally attributed to remodeling and progressive loss of pulmonary arterial vasculature that results in decreased capillary blood volume available for gas exchange.</p> <p>Methods</p> <p>We tested this hypothesis by determination of lung diffusing capacity (DL) and its components, the alveolar capillary membrane diffusing capacity (D<sub>m</sub>) and lung capillary blood volume (V<sub>c</sub>) in 28 individuals with PAH in comparison to 41 healthy individuals, and in 19 PAH patients over time. Using single breath simultaneous measure of diffusion of carbon monoxide (DL<sub>CO</sub>) and nitric oxide (DL<sub>NO</sub>), DL and D<sub>m</sub> were respectively determined, and V<sub>c</sub> calculated. D<sub>m</sub> and V<sub>c</sub> were evaluated over time in relation to standard clinical indicators of disease severity, including brain natriuretic peptide (BNP), 6-minute walk distance (6MWD) and right ventricular systolic pressure (RVSP) by echocardiography.</p> <p>Results</p> <p>Both DL<sub>CO</sub> and DL<sub>NO</sub> were reduced in PAH as compared to controls and the lower DL in PAH was due to loss of both D<sub>m</sub> and V<sub>c</sub> (all p < 0.01). While DL<sub>CO</sub> of PAH patients did not change over time, DL<sub>NO</sub> decreased by 24 ml/min/mmHg/year (p = 0.01). Consequently, D<sub>m</sub> decreased and V<sub>c</sub> tended to increase over time, which led to deterioration of the D<sub>m</sub>/V<sub>c</sub> ratio, a measure of alveolar-capillary membrane functional efficiency without changes in clinical markers.</p> <p>Conclusions</p> <p>The findings indicate that lower than normal gas transfer in PAH is due to loss of both D<sub>m</sub> and V<sub>c</sub>, but that deterioration of D<sub>m</sub>/V<sub>c</sub> over time is related to worsening membrane diffusion.</p> http://respiratory-research.com/content/14/1/6Membrane diffusionPulmonary arterial hypertensionLung capillary blood volume
collection DOAJ
language English
format Article
sources DOAJ
author Farha Samar
Laskowski Daniel
George Deepa
Park Margaret M
Tang WH Wilson
Dweik Raed A
Erzurum Serpil C
spellingShingle Farha Samar
Laskowski Daniel
George Deepa
Park Margaret M
Tang WH Wilson
Dweik Raed A
Erzurum Serpil C
Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
Respiratory Research
Membrane diffusion
Pulmonary arterial hypertension
Lung capillary blood volume
author_facet Farha Samar
Laskowski Daniel
George Deepa
Park Margaret M
Tang WH Wilson
Dweik Raed A
Erzurum Serpil C
author_sort Farha Samar
title Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
title_short Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
title_full Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
title_fullStr Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
title_full_unstemmed Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
title_sort loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension
publisher BMC
series Respiratory Research
issn 1465-9921
publishDate 2013-01-01
description <p>Abstract</p> <p>Background</p> <p>Reduced gas transfer in patients with pulmonary arterial hypertension (PAH) is traditionally attributed to remodeling and progressive loss of pulmonary arterial vasculature that results in decreased capillary blood volume available for gas exchange.</p> <p>Methods</p> <p>We tested this hypothesis by determination of lung diffusing capacity (DL) and its components, the alveolar capillary membrane diffusing capacity (D<sub>m</sub>) and lung capillary blood volume (V<sub>c</sub>) in 28 individuals with PAH in comparison to 41 healthy individuals, and in 19 PAH patients over time. Using single breath simultaneous measure of diffusion of carbon monoxide (DL<sub>CO</sub>) and nitric oxide (DL<sub>NO</sub>), DL and D<sub>m</sub> were respectively determined, and V<sub>c</sub> calculated. D<sub>m</sub> and V<sub>c</sub> were evaluated over time in relation to standard clinical indicators of disease severity, including brain natriuretic peptide (BNP), 6-minute walk distance (6MWD) and right ventricular systolic pressure (RVSP) by echocardiography.</p> <p>Results</p> <p>Both DL<sub>CO</sub> and DL<sub>NO</sub> were reduced in PAH as compared to controls and the lower DL in PAH was due to loss of both D<sub>m</sub> and V<sub>c</sub> (all p < 0.01). While DL<sub>CO</sub> of PAH patients did not change over time, DL<sub>NO</sub> decreased by 24 ml/min/mmHg/year (p = 0.01). Consequently, D<sub>m</sub> decreased and V<sub>c</sub> tended to increase over time, which led to deterioration of the D<sub>m</sub>/V<sub>c</sub> ratio, a measure of alveolar-capillary membrane functional efficiency without changes in clinical markers.</p> <p>Conclusions</p> <p>The findings indicate that lower than normal gas transfer in PAH is due to loss of both D<sub>m</sub> and V<sub>c</sub>, but that deterioration of D<sub>m</sub>/V<sub>c</sub> over time is related to worsening membrane diffusion.</p>
topic Membrane diffusion
Pulmonary arterial hypertension
Lung capillary blood volume
url http://respiratory-research.com/content/14/1/6
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