Pulmonary artery pressure-flow relation during exercise in highlanders vs. lowlanders

We studied the effects of changes in pulmonary capillary wedge pressure (PCWP) on the slope (incremental resistance) and the extrapolated pressure intercept (PI) of the mean pulmonary artery pressure (PAP)-cardiac output (CO) relationship. Multipoint plots of PAP against CO were obtained in intact anesthetized dogs. Group 1 consisted of six dogs entirely in West zone 3 and group 2 of four dogs with mixed West zone 2-3. The four conditions studied were the following: 1) fixed low PCWP, 2) fixed high PCWP, 3) variable PCWP, and 4) time-control repeat of condition 1. The PI significantly exceeded PCWP at fixed low PCWP (group 1, 9.3 vs. 11.1 mmHg, group 2, 6.6 vs. 3.9 mmHg). PI became identical to PCWP only at fixed high PCWP in group 1 (19 +/- 2.0 vs. 19 +/- 1.1 mmHg). Thus PCWP reflects the effective vascular outflow pressure when PCWP is fixed and high. For both groups of dogs in condition 3, when PCWP was varied with CO, the slope of the resulting PAP-CO plot was significantly greater than when PCWP was constant. Also in 9 of 10 dogs, PI was less than PCWP when PCWP was varied. These findings demonstrate that when changes in PCWP are allowed to occur during the generation of a pulmonary artery pressure-flow plot, the resulting slope and intercept, as defined by a Starling resistor model, do not accurately represent the incremental resistance and outflow pressure of the pulmonary vasculature.

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Effects of altered hematocrit on pulmonary artery pressure-flow characteristics in canine pulmonary embolism

Journal of Critical Care ◽

10.1016/0883-9441(90)90007-v ◽

1990 ◽

Vol 5 (1) ◽

pp. 35-41

Author(s):

John Ducas ◽

Robert Kischuk ◽

Usha Schick ◽

Richard M. Prewitt

Keyword(s):

Pulmonary Embolism ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Flow Characteristics ◽

Pressure Flow ◽

Artery Pressure

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Pulmonary artery pressure: flow relationships in hyperoxic and in hypoxic dogs

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.1988.tb02704.x ◽

1988 ◽

Vol 32 (2) ◽

pp. 147-151 ◽

Cited By ~ 5

Author(s):

M. Leeman ◽

P. Lejeune ◽

C. Mélot ◽

T. Deloof ◽

R. Naeije

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Pressure Flow ◽

Artery Pressure

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Pulmonary Artery Pressure–Flow Relations after Prostacyclin in Primary Pulmonary Hypertension

American Journal of Respiratory and Critical Care Medicine ◽

10.1164/ajrccm.165.3.2106033 ◽

2002 ◽

Vol 165 (3) ◽

pp. 338-340 ◽

Cited By ~ 63

Author(s):

VINCENT CASTELAIN ◽

DENIS CHEMLA ◽

MARC HUMBERT ◽

OLIVIER SITBON ◽

GERALD SIMONNEAU ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Primary Pulmonary Hypertension ◽

Pressure Flow ◽

Artery Pressure

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Doppler predictions of pulmonary artery pressure, flow, and resistance in adults

American Heart Journal ◽

10.1016/0002-8703(87)90658-2 ◽

1987 ◽

Vol 113 (6) ◽

pp. 1426-1436 ◽

Cited By ~ 34

Author(s):

William F. Graettinger ◽

Ernest R. Greene ◽

Wyatt F. Voyles

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Pressure Flow ◽

Artery Pressure

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Effects of Progressive Vascular Occlusion on Slope and Intercept of the Pulmonary Artery Pressure-Flow Relationship

Angiology ◽

10.1177/000331979504600106 ◽

1995 ◽

Vol 46 (1) ◽

pp. 45-52

Author(s):

Shian Gu ◽

Richard M. Prewitt ◽

Usha Schick ◽

John Ducas

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Vascular Occlusion ◽

Pressure Flow ◽

Artery Pressure

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Inflammation and Congenital Heart Disease Associated Pulmonary Hypertension

The Heart Surgery Forum ◽

10.1532/hsf.1228 ◽

2015 ◽

Vol 18 (1) ◽

pp. 038 ◽

Cited By ~ 2

Author(s):

Mete Gursoy ◽

Ece Salihoglu ◽

Ali Can Hatemi ◽

A. Faruk Hokenek ◽

Suleyman Ozkan ◽

...

Keyword(s):

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Neutrophil To Lymphocyte Ratio ◽

Cell Distribution ◽

Inflammation Markers ◽

Distribution Width ◽

Artery Pressure ◽

Lymphocyte Ratio ◽

Mean Pulmonary Artery Pressure ◽

Pulmonary Arterial

Background: Increased blood flow may trigger pulmonary arterial wall inflammation, which may influence progression of pulmonary artery hypertension in patients with congenital heart disease. In this study, we aimed to investigate the correlation between preoperative inflammation markers and pulmonary arterial hypertension. Methods: A total of 201 patients with pulmonary hypertension were enrolled in this study retrospectively; they had undergone open heart surgery between January 2012 and December 2013. Patients’ preoperative C-reactive protein (CRP), neutrophil to lymphocyte ratio, red blood cell distribution width, pulmonary pressures, and postoperative outcomes were evaluated. Results: Patient age, neutrophil to lymphocyte ratio, red blood cell distribution width, and CRP were found to be significantly correlated with both preoperative peak and mean pulmonary artery pressures. These data were entered into a linear logistic regression analysis. Patient age, neutrophil to lymphocyte ratio, and CRP were found to be independently correlated with peak pulmonary pressure (P < .001, P < .001, and P = .004) and mean pulmonary artery pressure (P < .001, P < .001, and P = .001), whereas preoperative mean pulmonary artery pressure was found to be independently correlated with intensive care unit stay (P < .001). No parameter was found to be significantly correlated with extubation time and mortality. Eighteen patients had experienced pulmonary hypertensive crisis; in this subgroup, patients’ mean pulmonary artery pressure and neutrophil to lymphocyte ratio were found to be significant (P = .047, P = .003). Conclusion: Preoperative inflammation markers may be correlated with the progression of pulmonary hypertensive disease, but further studies with larger sample size are needed to determine the predictive role of these markers for postoperative outcomes.

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