Alveolar-capillary membrane gas conductance: A novel prognostic indicator in chronic heart failure

Marco Guazzi, G. Pontone, R. Brambilla, P. Agostoni, G. Rèina

Research output: Contribution to journalArticle

Abstract

Aims: Lung dysfunction occurring in chronic heart failure worsens clinical status and exercise performance. The prognostic value of airway and alveolar function measurements in chronic heart failure has not been explored. We aimed to evaluate the prognostic value of lung function tests in a population of patients with stable chronic heart failure. Methods and Results: One hundred and six stable chronic heart failure patients (whose left ventricular ejection fraction averaged 33± 1%) underwent echocardiography, metabolic stress testing, assessment of pulmonary function at rest (by spirometry), of alveolar diffusing capacity (DLco) (with carbon monoxide technique) and of its membrane (DM) and capillary blood volume (Vc) components. Prognostic relevance of pulmonary variables was assessed by the Kaplan-Meier approach with log-rank testing and by Cox regression analysis. Cut-off values of lung parameters were based on the 33rd and 66th centiles. Seventeen patients died for cardiac reasons. Non-survivors compared to survivors showed lower forced expiratory volume in I 1 s (2·1 ± 0·1 vs 2·4±0·11; Pco (16·5 ± 1·1 vs 19·3 ± 0·6 ml. min -1 . mmHg-1; PM (25·1 ± 1·8 vs 31·9 ± 1·5 ml . min -1 . mmHg -1; P2 (14·6 ±± 0·7 vs 15·9 ± 0·6 ml. min -1 . kg -1; P2 slope (45·0 ± 1·7 vs 41·9 ± 1·5;, P<0·01). Multivariate analysis revealed that DM was the only independent predictor of cardiac death. Cases at high risk for adverse outcome were identified by a DM-1 . mmHg-1 Patients receiving ACE-inhibitors presented with a higher DM (32·1 ± 1·7 vs 27·9 ± PM is a powerful independent predictor of worse prognosis in stable chronic heart failure and may be considered an additional index of disease severity, as well as a specific therapeutic target.

Original languageEnglish
Pages (from-to)467-476
Number of pages10
JournalEuropean Heart Journal
Volume23
Issue number6
DOIs
Publication statusPublished - Mar 2002

Fingerprint

Heart Failure
Gases
Membranes
Lung
Physiological Stress
Spirometry
Respiratory Function Tests
Forced Expiratory Volume
Carbon Monoxide
Blood Volume
Angiotensin-Converting Enzyme Inhibitors
Stroke Volume
Survivors
Echocardiography
Multivariate Analysis
Regression Analysis
Exercise
Population
Therapeutics

Keywords

  • Heart failure
  • Pulmonary function
  • Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Alveolar-capillary membrane gas conductance : A novel prognostic indicator in chronic heart failure. / Guazzi, Marco; Pontone, G.; Brambilla, R.; Agostoni, P.; Rèina, G.

In: European Heart Journal, Vol. 23, No. 6, 03.2002, p. 467-476.

Research output: Contribution to journalArticle

@article{0305a544144c4cab8e09a50908bbee84,
title = "Alveolar-capillary membrane gas conductance: A novel prognostic indicator in chronic heart failure",
abstract = "Aims: Lung dysfunction occurring in chronic heart failure worsens clinical status and exercise performance. The prognostic value of airway and alveolar function measurements in chronic heart failure has not been explored. We aimed to evaluate the prognostic value of lung function tests in a population of patients with stable chronic heart failure. Methods and Results: One hundred and six stable chronic heart failure patients (whose left ventricular ejection fraction averaged 33± 1{\%}) underwent echocardiography, metabolic stress testing, assessment of pulmonary function at rest (by spirometry), of alveolar diffusing capacity (DLco) (with carbon monoxide technique) and of its membrane (DM) and capillary blood volume (Vc) components. Prognostic relevance of pulmonary variables was assessed by the Kaplan-Meier approach with log-rank testing and by Cox regression analysis. Cut-off values of lung parameters were based on the 33rd and 66th centiles. Seventeen patients died for cardiac reasons. Non-survivors compared to survivors showed lower forced expiratory volume in I 1 s (2·1 ± 0·1 vs 2·4±0·11; Pco (16·5 ± 1·1 vs 19·3 ± 0·6 ml. min -1 . mmHg-1; PM (25·1 ± 1·8 vs 31·9 ± 1·5 ml . min -1 . mmHg -1; P2 (14·6 ±± 0·7 vs 15·9 ± 0·6 ml. min -1 . kg -1; P2 slope (45·0 ± 1·7 vs 41·9 ± 1·5;, P<0·01). Multivariate analysis revealed that DM was the only independent predictor of cardiac death. Cases at high risk for adverse outcome were identified by a DM-1 . mmHg-1 Patients receiving ACE-inhibitors presented with a higher DM (32·1 ± 1·7 vs 27·9 ± PM is a powerful independent predictor of worse prognosis in stable chronic heart failure and may be considered an additional index of disease severity, as well as a specific therapeutic target.",
keywords = "Heart failure, Pulmonary function, Survival",
author = "Marco Guazzi and G. Pontone and R. Brambilla and P. Agostoni and G. R{\`e}ina",
year = "2002",
month = "3",
doi = "10.1053/euhj.2001.2803",
language = "English",
volume = "23",
pages = "467--476",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Alveolar-capillary membrane gas conductance

T2 - A novel prognostic indicator in chronic heart failure

AU - Guazzi, Marco

AU - Pontone, G.

AU - Brambilla, R.

AU - Agostoni, P.

AU - Rèina, G.

PY - 2002/3

Y1 - 2002/3

N2 - Aims: Lung dysfunction occurring in chronic heart failure worsens clinical status and exercise performance. The prognostic value of airway and alveolar function measurements in chronic heart failure has not been explored. We aimed to evaluate the prognostic value of lung function tests in a population of patients with stable chronic heart failure. Methods and Results: One hundred and six stable chronic heart failure patients (whose left ventricular ejection fraction averaged 33± 1%) underwent echocardiography, metabolic stress testing, assessment of pulmonary function at rest (by spirometry), of alveolar diffusing capacity (DLco) (with carbon monoxide technique) and of its membrane (DM) and capillary blood volume (Vc) components. Prognostic relevance of pulmonary variables was assessed by the Kaplan-Meier approach with log-rank testing and by Cox regression analysis. Cut-off values of lung parameters were based on the 33rd and 66th centiles. Seventeen patients died for cardiac reasons. Non-survivors compared to survivors showed lower forced expiratory volume in I 1 s (2·1 ± 0·1 vs 2·4±0·11; Pco (16·5 ± 1·1 vs 19·3 ± 0·6 ml. min -1 . mmHg-1; PM (25·1 ± 1·8 vs 31·9 ± 1·5 ml . min -1 . mmHg -1; P2 (14·6 ±± 0·7 vs 15·9 ± 0·6 ml. min -1 . kg -1; P2 slope (45·0 ± 1·7 vs 41·9 ± 1·5;, P<0·01). Multivariate analysis revealed that DM was the only independent predictor of cardiac death. Cases at high risk for adverse outcome were identified by a DM-1 . mmHg-1 Patients receiving ACE-inhibitors presented with a higher DM (32·1 ± 1·7 vs 27·9 ± PM is a powerful independent predictor of worse prognosis in stable chronic heart failure and may be considered an additional index of disease severity, as well as a specific therapeutic target.

AB - Aims: Lung dysfunction occurring in chronic heart failure worsens clinical status and exercise performance. The prognostic value of airway and alveolar function measurements in chronic heart failure has not been explored. We aimed to evaluate the prognostic value of lung function tests in a population of patients with stable chronic heart failure. Methods and Results: One hundred and six stable chronic heart failure patients (whose left ventricular ejection fraction averaged 33± 1%) underwent echocardiography, metabolic stress testing, assessment of pulmonary function at rest (by spirometry), of alveolar diffusing capacity (DLco) (with carbon monoxide technique) and of its membrane (DM) and capillary blood volume (Vc) components. Prognostic relevance of pulmonary variables was assessed by the Kaplan-Meier approach with log-rank testing and by Cox regression analysis. Cut-off values of lung parameters were based on the 33rd and 66th centiles. Seventeen patients died for cardiac reasons. Non-survivors compared to survivors showed lower forced expiratory volume in I 1 s (2·1 ± 0·1 vs 2·4±0·11; Pco (16·5 ± 1·1 vs 19·3 ± 0·6 ml. min -1 . mmHg-1; PM (25·1 ± 1·8 vs 31·9 ± 1·5 ml . min -1 . mmHg -1; P2 (14·6 ±± 0·7 vs 15·9 ± 0·6 ml. min -1 . kg -1; P2 slope (45·0 ± 1·7 vs 41·9 ± 1·5;, P<0·01). Multivariate analysis revealed that DM was the only independent predictor of cardiac death. Cases at high risk for adverse outcome were identified by a DM-1 . mmHg-1 Patients receiving ACE-inhibitors presented with a higher DM (32·1 ± 1·7 vs 27·9 ± PM is a powerful independent predictor of worse prognosis in stable chronic heart failure and may be considered an additional index of disease severity, as well as a specific therapeutic target.

KW - Heart failure

KW - Pulmonary function

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=0036522191&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036522191&partnerID=8YFLogxK

U2 - 10.1053/euhj.2001.2803

DO - 10.1053/euhj.2001.2803

M3 - Article

C2 - 11863349

AN - SCOPUS:0036522191

VL - 23

SP - 467

EP - 476

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 6

ER -