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Pulmonary blood volume: Analysis during exercise in patients with left ventricular dysfunction

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Abstract

Recent reports have demonstrated substantial increases in pulmonary activity during radionuclide stress exercise studies in patients with coronary heart disease. These studies have shown that the degree of the increase reflected the severity of the underlying disease. We studied the effects of supine exercise on systolic function and pulmonary activity in ten normal control subjects and 20 patients with congestive cardiomyopathy (12 ischemic and 8 idiopathic). Ejection fraction rose in the normals (P<0.001), end-diastolic volume increased slightly but significantly (P<0.05), and pulmonary activity rose by less than 16%, (mean 10%) while cardiac output increased by 162%. On the other hand, the myopathy patients demonstrated a small increase in cardiac output, (+49%) with a more substantial increase in pulmonary activity (+25%, P<0.05 vs normals). In these patients, ejection fraction did not change during exercise, while end-diastolic and end-systolic volumes rose. In the myopathy patients, the cause for an increase in cardiac output was a rise in heart rate, with little change in stroke volume. We conclude that pulmonary activity rises in myopathy patients to a greater extent than in normal controls. This probably reflects the greater elevation in filling pressures these patients need to maintain forward cardiac output.

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References

  1. Okada R, Pohost G, Kirschenbaum H, Kirshner K, Boucher C, Block P, Strauss HW (1979) Radionuclide-determined changes in pulmonary blood volume with exercise. New Engl J Med 301:569–576

    Google Scholar 

  2. Nichols A, Strauss HW, Moore R, Guiney T, Cochavi S, Beller G, Pohost G (1979) Acute changes in cardiopulmonary blood volume during upright exercise stress testing in patients with coronary artery disease. Circulation 60:520–530

    Google Scholar 

  3. Lindsey A, Guyton A (1959) Continuous recording of pulmonary blood volume: pulmonary pressure and volume changes. Am J Physiol 192:959–962

    Google Scholar 

  4. Bingham J, McKusick K, Strauss HW, Boucher C, Pohost G (1980) Influence of coronary artery disease on pulmonary uptake of Thallium 201. Am J Cardiol 46:821–826

    Google Scholar 

  5. Kushner F, Okada R, Kirschenbaum H, Boucher C, Strauss HW, Pohost G (1981) Lung thallium 201 uptake after stress testing in patients with coronary artery disease. Circulations 63:341–348

    Google Scholar 

  6. Boucher C, Zir L, Beller G, Okada R, McKusick K, Strauss HW, Pohost G (1980) Increased lung uptake of thallium-201 and angiographic implications in patients with coronary artery disease. Am J Cardiol 46:189–203

    Google Scholar 

  7. Slutsky R, Tubau J, Bhargava V, Higgins C, Costello D, Le Winter M (1982) Pulmonary blood volume: correlation of equilibrium radionuclide and dyedilution estimates. Invest Radiol 17:233–240

    Google Scholar 

  8. Slutsky R, Pfisterer M, Verba J, Battler A, Ashburn W (1980) Equilibrium radionuclide angiography: Influence of different background and left ventricular assignments on ejection fraction. Radiology 132:158–159

    Google Scholar 

  9. Slutsky R, Karliner J, Ricci D, Pfisterer M, Peterson K, Ashburn W (1979) Left ventricular volumes from equilibrium radionuclide angiography: a new method. Circulation 59:556–564

    Google Scholar 

  10. Slutsky R, Walaski S, Gordon D, Battler A, Gerber K, Peterson K, Murray I, Ashburn W (1980) A simplified method for the calculation of left ventricular volumes by equilibrium radionuclide angiography. Cathet Cardiovasc Diagn 6:49–50

    Google Scholar 

  11. Slutsky R, Karliner J, Battler A, Pfisterer M, Swanson S, Ashburn W (1979) Reproducibility of ejection fraction and ventricular volume by gated radionuclide angiography after acute infarction. Radiology 132:155–161

    Google Scholar 

  12. Dehmer G, Lewis S, Hillis L, Tweig G, Falkoff M, Parkey R, Willerson J (1980) A non-geometric method for scintigraphic determination of left ventricular volume from gated cardiac blood pool scan. Am J Cardiol 35:293–299

    Google Scholar 

  13. Maurer A, Siegel J, Denenberg B, Carabello B, Spann J, Malmud L (1983) Absolute left ventricular volume from gated blood pool imaging with use of esophageal transmission measurements. Am J Cardiol 51:853–858

    Google Scholar 

  14. Massie B, Kramer B, Gertz E, Henderson S (1982) Measurement determination of left ventricular volume; comparison of count-based and geometric methods. Circulation 65:725–731

    Google Scholar 

  15. Links J, Becker L, Schindledecker G, Guzman P, Burow R, Nickolof E, Alderson P, Wagner J Jr (1982) Measurement of absolute left ventricular volume from gated cardiac blood pool scans. Circulation 65:82–89

    Google Scholar 

  16. Konstam M, Wynne J, Holman B, Brown G, Neill J, Kozlowski J (1981) use of equilibrium (gated) radionuclide ventriculography to quantitate left ventricular output in patients with and without left-sided valvular regurgitation. Circulation 64:578–585

    Google Scholar 

  17. Clements I, Brown M, Smith H (1981) Radionuclide measurement of left ventricular volume. Mayo Clin Proc 56:733–742

    Google Scholar 

  18. Dehmer G, Firth B, Lewis S, Willerson J, Hillis LD (1981) Direct measurement of cardiac output by gated equilibrium blood pool scintigraphy: validation of scintigraphic volume measurements by a nongeometric technique. Am J Cardiol 47:1061–1067

    Google Scholar 

  19. Sorenson S, Ritchie J, Caldwell J, Hamilton G, Kennedy J (1980) Serial exercise radionuclide angiography. Validation of count derived changes in cardiac output and quantitation of maximal exercise in ventricular volume change after nitroglycerin and propranol in normal man. Circulation 61:600–609

    Google Scholar 

  20. Boucher C, Bingham J, Osbakken M, Okada R, Strauss HW, Block P, Levine R, Phillips H, Pohost G (1981) Early changes in left ventricular size and function after correction of left ventricular volume overload. Am J Cardiol 47:991–1004

    Google Scholar 

  21. Slutsky R, Karliner J, Ricci D, Pfisterer M, Schuler G, Peterson K, Ashburn W (1979) Response of left ventricular volume to exercise in man with radionuclide equilibrium angiography. Circulation 60:565–572

    Google Scholar 

  22. Thompson H, Berry J, McIntosh H (1959) Comparison of the cardiac output response to hyperventilation and exercise. Clin Res 7:136

    Google Scholar 

  23. Roncoroni A, Aremendia P, Gonzalez R, Tquini A (1959) “Central” blood volume in normal subjects. Acta Physiol Lat Am 9:55–62

    Google Scholar 

  24. Braunwald E, Kelly E (1960) Effects of exercise on central blood volume in man. J Clin Invest 39:413–422

    Google Scholar 

  25. Marshall R, Shepherd J (1961) Interpretation of changes in “central blood volume” and slope volume during exercise in man. J Clin Invest 40:375–382

    Google Scholar 

  26. Upton M, Rerych S, Newman G, Bounovs E, Jones R (1980) The reproducibility of radionuclide angiographic measurements of left ventricular function on normal subjects at rest and during exercise. Circulation 62:126–131

    Google Scholar 

  27. Rapaport E, Kulda H, Haynes F, Dexter L (1956) The pulmonary blood volume in mitral stenosis. J Clin Invest 35:1393–1400

    Google Scholar 

  28. Ball JD, Kopelman H, Witham AL (1952) Circulatory changes in mitral stenosis at rest and on exercise. Br Heart J 14:363–369

    Google Scholar 

  29. Schreiner B, Murphy G, Glick G, Yu P (1963) The effects of exercise on the pulmonary blood volume in patients with acquired heart disease. Circulation 27:559–564

    Google Scholar 

  30. Newman G, Rerych S, Upton M, Sabiston D, Jones R (1980) Comparison of electrocardiographic and left ventricular function changes during exercise. Circulation 62:1204–1211

    Google Scholar 

  31. Lanari A, Angrest A (1954) Pressure-volume relationship in the pulmonary vascular bed. Acta Physiol Lat Am 4:116–154

    Google Scholar 

  32. Sarnoff S, Berglund E (1952) Pressure-volume characteristics and stress relaxation in the pulmonary wascular bed of the dog. Am J Physiol 171:238–246

    Google Scholar 

  33. Yu P, Murphy G, Schreiner B, James D (1967) Distensibility characteristics of the human pulmonary bed. Circulation 35:710–716

    Google Scholar 

  34. Lichtenberg R, Iskrandan A, Segal B, Kanes, Bruec C (1980) Circulatory responses during upright bicycle exercise in patients with left ventricular dysfunction. Circ 62:Suppl II, 130 (abstract)

    Google Scholar 

  35. Lewis B, Un T, Noe F, Komisaruk R (1958) Measurement of pulmonary capillary blood volume and pulmonary membrane diffusing capacity in normal subjects: effects of exercise and position. J Clin Invest 37:1061–1067

    Google Scholar 

  36. Johnson R, Spicer W, Bishop J, Forster R (1960) Pulmonary capillary blood volume, flow and diffusing capacity during exercise. J Appl Physiol 15:883–892

    Google Scholar 

  37. Slutsky R (1982) Pulmonary blood volume: the response to afterload in normal subjects and patients with previous myocardial infarction. Inest Radiol 17:241–247

    Google Scholar 

  38. Tubau J, Slutsky R, Gerber K, Peterson K, Ashburn W, Higgins C, LeWinter M (1983) Pulmonary blood volume: Relationship to changes in end-diastolic pressure during atrial pacing. Am Heart J 105:940–945

    Google Scholar 

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Authors and Affiliations

  1. Division of Cardiology and Pulmonary Medicine, Department of Medicine, San Diego Veterans Administration Medical Center, 92161, San Diego, CA, USA

    R. A. Slutsky, R. Shabetai, M. LeWinter, C. Higgins & G. B. J. Mancini

  2. Department of Radiology, San Diego Veterans Administration Medical Center, 92161, San Diego, CA, USA

    R. A. Slutsky, R. Shabetai, M. LeWinter, C. Higgins & G. B. J. Mancini

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  1. R. A. Slutsky
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  2. R. Shabetai
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  3. M. LeWinter
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  4. C. Higgins
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  5. G. B. J. Mancini
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Slutsky, R.A., Shabetai, R., LeWinter, M. et al. Pulmonary blood volume: Analysis during exercise in patients with left ventricular dysfunction. Eur J Nucl Med 8, 523–527 (1983). https://doi.org/10.1007/BF00251613

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  • DOI: https://doi.org/10.1007/BF00251613

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