TY - JOUR
T1 - The alveolar to arterial oxygen partial pressure difference is associated with pulmonary diffusing capacity in heart failure patients
AU - Morosin, Marco
AU - Vignati, Carlo
AU - Novi, Angela
AU - Salvioni, Elisabetta
AU - Veglia, Fabrizio
AU - Alimento, Marina
AU - Merli, Guido
AU - Sciomer, Susanna
AU - Sinagra, Gianfranco
AU - Agostoni, Piergiuseppe
PY - 2016/11/1
Y1 - 2016/11/1
N2 - In chronic heart failure (HF), the alveolar-capillary membrane undergoes a remodeling process that negatively affects gas exchange. In case of alveolar-capillary gas diffusion impairment, arterial desaturation (SaO2) is rarely observed in HF patients. At play are 3 factors: overall pulmonary diffusing capacity (assessed as lung diffusion for CO, DLCO), global O2 consumption (VO2) and alveolar (A) to arterial (a) pO2 gradient (AaDO2). In 100 consecutive stable HF patients, DLCO, resting respiratory gases and arterial blood gases were measured to determine VO2, paO2, pAO2 and AaDO2. DLCO was poorly but significantly related to AaDO2. The correlation improved after correcting AaDO2 for VO2 (p 2 and AaDO2 were independently associated with DLCO (p 2 and pAO2. AaDO2/VO2 showed a higher gradient in patients with lower DLCO. AaDO2 increase and VO2 reduction allow preventing low SaO2 in HF patients with reduced DLCO. Accordingly, we suggest considering AaDO2 and VO2 combined and reporting AaDO2/VO2.
AB - In chronic heart failure (HF), the alveolar-capillary membrane undergoes a remodeling process that negatively affects gas exchange. In case of alveolar-capillary gas diffusion impairment, arterial desaturation (SaO2) is rarely observed in HF patients. At play are 3 factors: overall pulmonary diffusing capacity (assessed as lung diffusion for CO, DLCO), global O2 consumption (VO2) and alveolar (A) to arterial (a) pO2 gradient (AaDO2). In 100 consecutive stable HF patients, DLCO, resting respiratory gases and arterial blood gases were measured to determine VO2, paO2, pAO2 and AaDO2. DLCO was poorly but significantly related to AaDO2. The correlation improved after correcting AaDO2 for VO2 (p 2 and AaDO2 were independently associated with DLCO (p 2 and pAO2. AaDO2/VO2 showed a higher gradient in patients with lower DLCO. AaDO2 increase and VO2 reduction allow preventing low SaO2 in HF patients with reduced DLCO. Accordingly, we suggest considering AaDO2 and VO2 combined and reporting AaDO2/VO2.
KW - Arterial-alveolar oxygen gradient
KW - Cardiopulmonary exercise testing
KW - Diffusing capacity for carbon monoxide
KW - Heart failure
KW - Peak VO
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U2 - 10.1016/j.resp.2016.06.004
DO - 10.1016/j.resp.2016.06.004
M3 - Article
AN - SCOPUS:84979085520
VL - 233
SP - 1
EP - 6
JO - Respiratory Physiology and Neurobiology
JF - Respiratory Physiology and Neurobiology
SN - 1569-9048
ER -