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


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          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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          Author and article information

          S. Karger AG
          July 2001
          20 July 2001
          : 95
          : 3
          : 139-145
          Service des Maladies Respiratoires et Réanimation Respiratoire, et INSERM U14, CHU de Nancy-Brabois, Université H. Poincaré, Nancy, France
          47360 Cardiology 2001;95:139–145
          © 2001 S. Karger AG, Basel

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          Page count
          Figures: 2, Tables: 5, References: 22, Pages: 7
          Catheterization and Interventional Cardiology


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