Interpretation of High Wedge Pressure on Exercise in Patients with Chronic Obstructive Pulmonary Disease

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Abstract

In a retrospective review of patients subjected to right heart catheterization, case records from 109 consecutive patients with chronic obstructive pulmonary disease (COPD) and wedge pressure ≧15 mm Hg on exercise were analyzed. Patients were separated into group 1, resting wedge pressure (Pw) <15 mm Hg and difference between Pw and right atrial pressure (Pra) change on exercise <5 mm Hg (n = 54), group 2, same Pw at rest but increase in Pw on exercise ≧5 mm Hg, being higher than that of Pra (n = 34), and group 3, Pw ≧15 mm Hg at rest (n = 21). The occurrence of left heart disease increased from group 1 to group 3 (19, 53 and 71%, respectively), and the slope of the Pw/stroke index relationship was lowest in group 3. High Pw on exercise can be explained by the pressure rise in the cardiac fossa associated with lower lobe gas trapping in group 1, which showed the most severe airflow limitation, decreased left ventricular compliance in group 2, and heart failure in group 3.

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Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 2001

Publication date (Print): July 2001

Publication date (Electronic): 20 July 2001

Volume: 95

Issue: 3

Pages: 139-145

Affiliations

Service des Maladies Respiratoires et Réanimation Respiratoire, et INSERM U14, CHU de Nancy-Brabois, Université H. Poincaré, Nancy, France

Article

Publisher ID: 47360 Other ID: Cardiology 2001;95:139–145

DOI: 10.1159/000047360

PubMed ID: 11474159

SO-VID: 7f5a51c9-3ce3-4c3c-a56f-94292cef5bff

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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Interpretation of High Wedge Pressure on Exercise in Patients with Chronic Obstructive Pulmonary Disease

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Karger: Cardiovascular System

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