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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Pagnamenta, Alberto Vanderpool, Rebecca Brimioulle, Serge Naeije, Robert |
| Description | Country affiliation: Belgium Author Affiliation: Pagnamenta A ( Department of Physiology, Faculty of Medicine, Free University of Brussels, Brussels, Belgium.) |
| Abstract | The time constant of the pulmonary circulation, or product of pulmonary vascular resistance (PVR) and compliance (Ca), called the RC-time, has been reported to remain constant over a wide range of pressures, etiologies of pulmonary hypertension, and treatments. We wondered if increased wave reflection on proximal pulmonary vascular obstruction, like in operable chronic thromboembolic pulmonary hypertension, might also decrease the RC-time and thereby increase pulse pressure and right ventricular afterload. Pulmonary hypertension of variable severity was induced either by proximal obstruction (pulmonary arterial ensnarement) or distal obstruction (microembolism) eight anesthetized dogs. Pulmonary arterial pressures (Ppa) were measured with high-fidelity micromanometer-tipped catheters, and pulmonary flow with transonic technology. Pulmonary ensnarement increased mean Ppa, PVR, and characteristic impedance, decreased Ca and the RC-time (from 0.46 ± 0.07 to 0.30 ± 0.03 s), and increased the oscillatory component of hydraulic load (Wosc/Wtot) from 25 ± 2 to 29 ± 2%. Pulmonary microembolism increased mean Ppa and PVR, with no significant change in Ca and characteristic impedance, increased RC-time from 0.53 ± 0.09 to 0.74 ± 0.05 s, and decreased Wosc/Wtot from 26 ± 2 to 13 ± 2%. Pulse pressure increased more after pulmonary ensnarement than after microembolism. Concomitant measurements with fluid-filled catheters showed the same functional differences between the two types of pulmonary hypertension, with, however, an underestimation of Wosc. We conclude that pulmonary hypertension caused by proximal vs. distal obstruction is associated with a decreased RC-time and increased pulsatile component of right ventricular hydraulic load. |
| File Format | HTM / HTML |
| ISSN | 87507587 |
| e-ISSN | 15221601 |
| Journal | Journal of Applied Physiology |
| Issue Number | 11 |
| Volume Number | 114 |
| Language | English |
| Publisher | American Physiological Society |
| Publisher Date | 2013-06-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Discipline Physiology Pulmonary Artery Physiopathology Pulmonary Circulation Pulmonary Embolism Complications Vascular Resistance Ventricular Dysfunction, Right Etiology Animals Arterial Pressure Blood Flow Velocity Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Physiology Physiology (medical) Sports Science |
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