Impaired matching of perfusion and ventilation in heart failure detected by 133xenon

Lewis, N. P., Banning, A. P., Cooper, J. P., Shyam Sundar, A., Facey, P. E., Evans, W. D. ORCID: https://orcid.org/0000-0003-0013-8205 and Henderson, A. H. 1996. Impaired matching of perfusion and ventilation in heart failure detected by 133xenon. Basic Research in Cardiology 91 , pp. 45-49. 10.1007/BF00810523

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Abstract

In severe chronic heart failure (CHF) the ventilatory cost of CO2 elimination during exercise (VE/VCO 2) is increased, suggesting ventilation/perfusion (V/Q) mismatch. The relationship of exercise VE/VCO 2 regression slopem to deadspace ventilation was studied in 15 patients with CHF who underwent cardiopulmonary exercise testing and arterial blood gas monitoring. Regional lung ventilation and perfusion was studied, using 133xenon, at rest and peak exercise in a further group of 10 CHF patients and in five normal subjects. VE/VCO 2 slopem correlated well with deadspace ventilation at peak exercise in the 15 patients with CHF. We therefore used exercise VE/VCO 2 slopem to categorize CHF patients undergoing133xenon imaging into groups with increased (slopem>36) or normal (slopem<36) exercise deadspace ventilation. In normals, resting V/Q determined by133xenon showed a gravitational gradient, which improved on exercise as a result of relative increases and of relative reductions in regional perfusion; no significant changes in regional ventilation distribution were detected. In patients with CHF who had normal slopem (n=5), rest and exercise V/Q were similar to the normal subjects. In CHF patients with increased slopem (n=5) however, the resting gravitational gradient of V/Q was lost, and there were no significant changes in relative perfusion distribution on exercise. These findings suggest that the increased ventilatory cost of CO2 elimination found in certain patients with CHF is related to inability to coordinate and optimise the relative distribution of lung perfusion with respect to ventilation during exercise.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Springer
ISSN:	0300-8428
Last Modified:	10 Nov 2022 09:57
URI:	https://orca.cardiff.ac.uk/id/eprint/145214

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