Pulmonary arterial dynamics in congestive heart failure in humans: Significance of pulmonary arterial stiffness

T. R. Porter, D. Taylor, N. G. Pandian, J. V. Nixon, G. W. Vetrovec, P. K. Mohanty

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

We used intravascular ultrasound to image the distal pulmonary artery 3.0 to 7.0 mm in diameter combined with simultaneous measurements of pulmonary arterial (PA) pulse pressure measured at end expiration in 16 patients with congestive heart failure (CHF), 8 with normal PA pressure and 8 with elevated PA pressure, and in 8 control patients with normal left ventricular systolic function and normal PA pressures. We derived pulmonary arterial stiffness using Peterson's elastic strain modulus at rest and inresponse to intravenous dobutamine and nitroglycerin. Baseline pulmonary arterial stiffness was significantly increased in patients with pulmonary hypertension and CHF (898 ± 570 vs. 386 ± 292 mm Hg in control vs. 173 ± 57 mm Hg in CHF with normal PA pressures; p <.05, ANOVA). In the CHF patients, there was a strong correlation between mean PA pressure and PA stiffness (r = .72, p < .01) at baseline. At comparable mean PA pressure in a subgroup of patients, however, PA stiffness was still higher in the CHF patients who developed secondary pulmonary hypertension. Despite significant improvement in PA stiffness after nitroglycerin infusion in patients with heart failure and normal PA pressure (173 ± 57 mm Hg before to 120 ± 39 mm Hg after nitroglycerin; p = .03), there was a wide variery of stiffness responses in the patients with pulmonary hypertension that was not predicted by the change in mean PA pressure (r = .09, p = NS) or pulmonary vascular resistance. In contrast, dobutamine increased PA stiffness in both heart failure groups (391 ± 439 mm Hg before to 467 ± 505 mm Hg after dobutamine; p = .05) without altering mean PA pressure or pulmonary vascular resistance.

Original languageEnglish (US)
Pages (from-to)105-114
Number of pages10
JournalJournal of Vascular Medicine and Biology
Volume4
Issue number2-3
StatePublished - 1993

Keywords

  • heart failure
  • intravascular ultrasound
  • pulmonary artery stiffness
  • pulmonary hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Pulmonary arterial dynamics in congestive heart failure in humans: Significance of pulmonary arterial stiffness'. Together they form a unique fingerprint.

  • Cite this