|
 |
|
|||||||
|
|||||||||
Copyright ©ERS Journals Ltd 2002
Relationship of carbon dioxide tension in arterial blood to pulmonary wedge pressure in heart failure
Depts of Medicine of the 1 Toronto General and 2 Mount Sinai Hospitals/University Health Network, University of Toronto, Toronto, Ontario, Canada
CORRESPONDENCE: T.D. Bradley, NU 9-112 Toronto General Hospital/UHN, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada. Fax: 416 3404197
Keywords: arterial blood gas tensions, cardiopulmonary interactions, hypocapnia
Received: February 12, 2001
Accepted July 25, 2001
The present study was supported by grants from the Canadian Institutes of Health Research (MOP-11607) and from the Heart and Stroke Foundation of Ontario. G. Lorenzi-Filho was supported by research fellowships from Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, Brazil and the Dept of Medicine of the University of Toronto. E.R. Azevedo held a research fellowship from Astra Zeneca/Heart and Stroke Foundation of Canada. T.D. Bradley is a Senior Scientist of the Canadian Institutes of Health Research.
Hypocapnia contributes to the genesis of Cheyne-Stokes respiration and central sleep apnoea in patients with congestive heart failure (CHF) and is associated with increased mortality. However, the cause of hypocapnia in patients with chronic stable CHF is unknown. Since pulmonary congestion can induce hyperventilation via stimulation of pulmonary vagal afferents, the present study tested the hypothesis that in patients with CHF (carbon dioxide tension in arterial blood (Pa,CO2)) is inversely related to pulmonary capillary wedge pressure (PCWP), and that alterations in PCWP would cause inverse changes in Pa,CO2.
In 11 CHF patients undergoing diagnostic cardiac catheterization, haemodynamic variables and arterial blood gas tensions were measured simultaneously at baseline. In three patients, these measurements were repeated after coronary angiographic dye infusion and nitroglycerine infusion.
At baseline, Pa,CO2 correlated inversely with PCWP (r=–0.80, p=0.003). In the three patients in whom multiple measurements were made, acute alterations in PCWP caused inversely proportional changes in Pa,CO2.
The present study concludes that in patients with congestive heart failure, pulmonary capillary wedge pressure is an important determinant of carbon dioxide tension in arterial blood. These findings imply that hypocapnia in patients with chronic stable congestive heart failure is a respiratory manifestation of elevated left ventricular filling pressures.
This article has been cited by other articles:
|
|
 |
|
  R. Baruah, C. H. Manisty, A. Giannoni, K. Willson, Y. Mebrate, A. J. Baksi, B. Unsworth, N. Hadjiloizou, R. Sutton, J. Mayet, et al. Novel Use of Cardiac Pacemakers in Heart Failure to Dynamically Manipulate the Respiratory System Through Algorithmic Changes in Cardiac Output Circ Heart Fail, May 1, 2009; 2(3): 166 - 174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. J. Bell, C. Ferguson, V. Kehoe, and P. Haouzi Hypocapnia increases the prevalence of hypoxia-induced augmented breaths Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2009; 296(2): R334 - R344. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. N. Simantirakis, S. E. Schiza, N. S. Siafakas, and P. E. Vardas Sleep-disordered breathing in heart failure and the effect of cardiac resynchronization therapy Europace, September 1, 2008; 10(9): 1029 - 1033. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Lorenzi-Filho and P. R. Genta A New Straw in the Genesis of Cheyne-Stokes Respiration Chest, July 1, 2008; 134(1): 7 - 9. [Full Text] [PDF]
|
|
|
|
|
|
M. Arzt, R. Wensel, S. Montalvan, T. Schichtl, S. Schroll, S. Budweiser, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer Effects of Dynamic Bilevel Positive Airway Pressure Support on Central Sleep Apnea in Men With Heart Failure Chest, July 1, 2008; 134(1): 61 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Szollosi, B. R. Thompson, H. Krum, D. M. Kaye, and M. T. Naughton Impaired Pulmonary Diffusing Capacity and Hypoxia in Heart Failure Correlates With Central Sleep Apnea Severity Chest, July 1, 2008; 134(1): 67 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Yumino and T. D. Bradley Central Sleep Apnea and Cheyne-Stokes Respiration Proceedings of the ATS, February 15, 2008; 5(2): 226 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Torchio, C. Gulotta, P. Greco-Lucchina, A. Perboni, L. Avonto, H. Ghezzo, and J. Milic-Emili Orthopnea and tidal expiratory flow limitation in chronic heart failure. Chest, August 1, 2006; 130(2): 472 - 479. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Arzt and T. D. Bradley Treatment of Sleep Apnea in Heart Failure Am. J. Respir. Crit. Care Med., June 15, 2006; 173(12): 1300 - 1308. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Wensel, D. P. Francis, P. Georgiadou, A. Scott, S. Genth-Zotz, S. D. Anker, A. J.S. Coats, and M. F. Piepoli Exercise hyperventilation in chronic heart failure is not caused by systemic lactic acidosis Eur J Heart Fail, December 1, 2005; 7(7): 1105 - 1111. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Y. Gabor, D. A. Newman, V. Barnard-Roberts, V. Korley, I. Mangat, P. Dorian, and P. J. Hanly Improvement in Cheyne-Stokes respiration following cardiac resynchronisation therapy Eur. Respir. J., July 1, 2005; 26(1): 95 - 100. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Floras and T. D. Bradley Atrial Overdrive Pacing for Sleep Apnea: A Door Now Closed? Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 1 - 3. [Full Text] [PDF]
|
|
|
|
|
|
C. Nopmaneejumruslers, Y. Kaneko, V. Hajek, V. Zivanovic, and T. D. Bradley Cheyne-Stokes Respiration in Stroke: Relationship to Hypocapnia and Occult Cardiac Dysfunction Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 1048 - 1052. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Arzt, M. Schulz, R. Wensel, S. Montalvan, F. C. Blumberg, G. A. J. Riegger, and M. Pfeifer Nocturnal Continuous Positive Airway Pressure Improves Ventilatory Efficiency During Exercise in Patients With Chronic Heart Failure Chest, March 1, 2005; 127(3): 794 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Leite, A. J. Mansur, H. F. G. de Freitas, P. R. Chizola, E. A. Bocchi, M. Terra-Filho, J. A. Neder, and G. Lorenzi-Filho Periodic breathing during incremental exercise predicts mortality in patients with chronic heart failure evaluated for cardiac transplantation J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2175 - 2181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Bradley The ups and downs of periodic breathing: Implications for mortality in heart failure J. Am. Coll. Cardiol., June 18, 2003; 41(12): 2182 - 2184. [Full Text] [PDF]
|
|
|
|
|
|
R. S. T. Leung, J. S. Floras, G. Lorenzi-Filho, F. Rankin, P. Picton, and T. D. Bradley Influence of Cheyne-Stokes Respiration on Cardiovascular Oscillations in Heart Failure Am. J. Respir. Crit. Care Med., June 1, 2003; 167(11): 1534 - 1539. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. D. Bradley and J. S. Floras Sleep Apnea and Heart Failure: Part II: Central Sleep Apnea Circulation, April 8, 2003; 107(13): 1822 - 1826. [Full Text] [PDF]
|
|
|
|
|
|
P. Solin, D.M. Jackson, T. Roebuck, and M.T. Naughton Cardiac diastolic function and hypercapnic ventilatory responses in central sleep apnoea Eur. Respir. J., September 1, 2002; 20(3): 717 - 723. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |