help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Data Supplement
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Scharf, S. M.
Right arrow Articles by Fessler, H. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Scharf, S. M.
Right arrow Articles by Fessler, H. E.
American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 314-322, (2002)
© 2002 American Thoracic Society

Original Article

Hemodynamic Characterization of Patients with Severe Emphysema

Steven M. Scharf, Mobeen Iqbal, Cesar Keller, Gerald Criner, Shing Lee and Henry E. Fessler

Pulmonary and Critical Care Divisions, Long Island Jewish Medical Center, Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, New York; St. Louis University School of Medicine, St. Louis, Missouri; Temple University School of Medicine, Philadelphia, Pennsylvania; and Johns Hopkins Medical Institutions, Baltimore, Maryland

Correspondence and requests for reprints should be addressed to Steven M. Scharf, M.D., Ph.D., Pulmonary and Critical Care Division, University of Maryland Baltimore, 685 West Baltimore St., MSTF 800, Baltimore, MD 21201-1192. E-mail: sscharf{at}medicine.umaryland.edu

In 120 patients with severe emphysema evaluated for participation in the National Emphysema Treatment Trial, pulmonary hemodynamics and ventricular function were assessed. Pulmonary function tests were (%predicted): FEV1 = 27%; residual volume = 224.6%; diffusion capacity = 26.7%. In 90.8% of patients, end-expiratory pulmonary artery mean pressure was > 20 mm Hg; in 61.4%, end-expiratory wedge pressure was > 12 mm Hg. Cardiac index was normal. Mean pulmonary artery pressure correlated inversely with arterial PO2, and severity of emphysema, and directly with wedge pressure. Multiple stepwise regression revealed that arterial PO2 was not an independent predictor of mean pulmonary artery pressure. No correlation was found between indices of emphysema severity and PA pressures. Diastolic ventricular pressures were increased without evidence of systolic dysfunction. We conclude that (1) elevations of pulmonary vascular pressures are common, (2) pulmonary hypertension may be related to factors other than hypoxia, (3) pulmonary hypertension does not impair resting systemic O2 delivery, and (4) elevated cardiac diastolic pressures do not represent systolic dysfunction.

Key Words: emphysema • pulmonary hypertension • cardiovascular function




This article has been cited by other articles:


Home page
 ChestHome page
M. K. Steiner
World Health Organization Class III COPD-Associated Pulmonary Hypertension: Are We There Yet in Understanding the Pathobiology of the Disease?
Chest, September 1, 2009; 136(3): 658 - 659.
[Full Text] [PDF]

Home page
 ChestHome page
A. Chaouat, L. Savale, C. Chouaid, L. Tu, B. Sztrymf, M. Canuet, B. Maitre, B. Housset, C. Brandt, P. Le Corvoisier, et al.
Role for Interleukin-6 in COPD-Related Pulmonary Hypertension
Chest, September 1, 2009; 136(3): 678 - 687.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. W. Sims, D. J. Margolis, A. R. Localio, R. A. Panettieri, S. M. Kawut, and J. D. Christie
Impact of Pulmonary Artery Pressure on Exercise Function in Severe COPD
Chest, August 1, 2009; 136(2): 412 - 419.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. M. Hoeper, J. A. Barbera, R. N. Channick, P. M. Hassoun, I. M. Lang, A. Manes, F. J. Martinez, R. Naeije, H. Olschewski, J. Pepke-Zaba, et al.
Diagnosis, assessment, and treatment of non-pulmonary arterial hypertension pulmonary hypertension.
J. Am. Coll. Cardiol., June 30, 2009; 54(1 Suppl): S85 - S96.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
C. J. Jolley and J. Moxham
A physiological model of patient-reported breathlessness during daily activities in COPD
Eur. Respir. Rev., June 1, 2009; 18(112): 66 - 79.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
V. V. McLaughlin, S. L. Archer, D. B. Badesch, R. J. Barst, H. W. Farber, J. R. Lindner, M. A. Mathier, M. D. McGoon, M. H. Park, R. S. Rosenson, et al.
ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association Developed in Collaboration With the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association
J. Am. Coll. Cardiol., April 28, 2009; 53(17): 1573 - 1619.
[Full Text] [PDF]

Home page
 CirculationHome page
Writing Committee Members, V. V. McLaughlin, S. L. Archer, D. B. Badesch, R. J. Barst, H. W. Farber, J. R. Lindner, M. A. Mathier, M. D. McGoon, M. H. Park, et al.
ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association: Developed in Collaboration With the American College of Chest Physicians, American Thoracic Society, Inc., and the Pulmonary Hypertension Association
Circulation, April 28, 2009; 119(16): 2250 - 2294.
[Full Text] [PDF]

Home page
 J. Physiol.Home page
T. G. Smith, G. M. Balanos, Q. P. P. Croft, N. P. Talbot, K. L. Dorrington, P. J. Ratcliffe, and P. A. Robbins
The increase in pulmonary arterial pressure caused by hypoxia depends on iron status
J. Physiol., December 15, 2008; 586(24): 5999 - 6005.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. Chaouat, R. Naeije, and E. Weitzenblum
Pulmonary hypertension in COPD
Eur. Respir. J., November 1, 2008; 32(5): 1371 - 1385.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. M. Hoeper
Treating pulmonary hypertension in COPD: where do we start?
Eur. Respir. J., September 1, 2008; 32(3): 541 - 542.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
D. Stolz, H. Rasch, A. Linka, M. Di Valentino, A. Meyer, M. Brutsche, and M. Tamm
A randomised, controlled trial of bosentan in severe COPD
Eur. Respir. J., September 1, 2008; 32(3): 619 - 628.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G.-C. Funk, I. Lang, P. Schenk, A. Valipour, S. Hartl, and O. C. Burghuber
Left Ventricular Diastolic Dysfunction in Patients With COPD in the Presence and Absence of Elevated Pulmonary Arterial Pressure
Chest, June 1, 2008; 133(6): 1354 - 1359.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
O. A. Minai, J. Benditt, and F. J. Martinez
Natural History of Emphysema
Proceedings of the ATS, May 1, 2008; 5(4): 468 - 474.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
J. A. Falk, S. Kadiev, G. J. Criner, S. M. Scharf, O. A. Minai, and P. Diaz
Cardiac Disease in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, May 1, 2008; 5(4): 543 - 548.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
A. Churg, M. Cosio, and J. L. Wright
Mechanisms of cigarette smoke-induced COPD: insights from animal models
Am J Physiol Lung Cell Mol Physiol, April 1, 2008; 294(4): L612 - L631.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. J. Lederer, E. K. T. Benn, R. G. Barr, J. S. Wilt, G. Reilly, J. R. Sonett, S. M. Arcasoy, and S. M. Kawut
Racial Differences in Waiting List Outcomes in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., February 15, 2008; 177(4): 450 - 454.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. H. Alzeer, A. F. Al-Mobeirek, H. A. K. Al-Otair, U. A. F. Elzamzamy, I. A. Joherjy, and A. S. Shaffi
Right and Left Ventricular Function and Pulmonary Artery Pressure in Patients With Bronchiectasis*
Chest, February 1, 2008; 133(2): 468 - 473.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. K. Han, V. V. McLaughlin, G. J. Criner, and F. J. Martinez
Pulmonary Diseases and the Heart
Circulation, December 18, 2007; 116(25): 2992 - 3005.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. R. Fisher, G. J. Criner, A. P. Fishman, P. M. Hassoun, O. A. Minai, S. M. Scharf, a. H. E. Fessler, and for the National Emphysema Treatment Trial (NETT)
Estimating pulmonary artery pressures by echocardiography in patients with emphysema
Eur. Respir. J., November 1, 2007; 30(5): 914 - 921.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. A. Falk, U. J. Martin, S. Scharf, and G. J. Criner
Lung Elastic Recoil Does Not Correlate With Pulmonary Hemodynamics in Severe Emphysema
Chest, November 1, 2007; 132(5): 1476 - 1484.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. J. Criner, S. M. Scharf, J. A. Falk, J. P. Gaughan, A. L. Sternberg, N. B. Patel, H. E. Fessler, O. A. Minai, A. P. Fishman, and for the National Emphysema Treatment Trial Researc
Effect of Lung Volume Reduction Surgery on Resting Pulmonary Hemodynamics in Severe Emphysema
Am. J. Respir. Crit. Care Med., August 1, 2007; 176(3): 253 - 260.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
C. Nadziejko, K. Fang, A. Bravo, and T. Gordon
Susceptibility to pulmonary hypertension in inbred strains of mice exposed to cigarette smoke
J Appl Physiol, May 1, 2007; 102(5): 1780 - 1785.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
K. Jorgensen, E. Houltz, U. Westfelt, and S.-E. Ricksten
Left Ventricular Performance and Dimensions in Patients with Severe Emphysema
Anesth. Analg., April 1, 2007; 104(4): 887 - 892.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. A. Fisher, D. M. Serlin, K. C. Wilson, R. E. Walter, J. S. Berman, and H. W. Farber
Sarcoidosis-Associated Pulmonary Hypertension: Outcome With Long-term Epoprostenol Treatment.
Chest, November 1, 2006; 130(5): 1481 - 1488.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
H. A. Ghofrani, R. Voswinckel, F. Reichenberger, N. Weissmann, R. T. Schermuly, W. Seeger, and F. Grimminger
Hypoxia- and non-hypoxia-related pulmonary hypertension - Established and new therapies
Cardiovasc Res, October 1, 2006; 72(1): 30 - 40.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
V. V. McLaughlin and M. D. McGoon
Pulmonary Arterial Hypertension
Circulation, September 26, 2006; 114(13): 1417 - 1431.
[Full Text] [PDF]

Home page
 ThoraxHome page
D E O'Donnell and C M Parker
COPD exacerbations {middle dot} 3: Pathophysiology.
Thorax, April 1, 2006; 61(4): 354 - 361.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. L. Wright, H. Tai, and A. Churg
Vasoactive mediators and pulmonary hypertension after cigarette smoke exposure in the guinea pig
J Appl Physiol, February 1, 2006; 100(2): 672 - 678.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. Chaouat, A.-S. Bugnet, N. Kadaoui, R. Schott, I. Enache, A. Ducolone, M. Ehrhart, R. Kessler, and E. Weitzenblum
Severe Pulmonary Hypertension and Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., July 15, 2005; 172(2): 189 - 194.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J L Wright, R D Levy, and A Churg
Pulmonary hypertension in chronic obstructive pulmonary disease: current theories of pathogenesis and their implications for treatment
Thorax, July 1, 2005; 60(7): 605 - 609.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Vonk-Noordegraaf, J. T. Marcus, S. Holverda, B. Roseboom, and P. E. Postmus
Early Changes of Cardiac Structure and Function in COPD Patients With Mild Hypoxemia
Chest, June 1, 2005; 127(6): 1898 - 1903.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. F. Shorr, D. L. Helman, D. B. Davies, and S. D. Nathan
Pulmonary hypertension in advanced sarcoidosis: epidemiology and clinical characteristics
Eur. Respir. J., May 1, 2005; 25(5): 783 - 788.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. Weitzenblum and A. Chaouat
Severe Pulmonary Hypertension in COPD: Is It a Distinct Disease?
Chest, May 1, 2005; 127(5): 1480 - 1482.
[Full Text] [PDF]

Home page
 ChestHome page
G. Thabut, G. Dauriat, J. B. Stern, D. Logeart, A. Levy, R. Marrash-Chahla, and H. Mal
Pulmonary Hemodynamics in Advanced COPD Candidates for Lung Volume Reduction Surgery or Lung Transplantation
Chest, May 1, 2005; 127(5): 1531 - 1536.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
T. Higenbottam
Pulmonary Hypertension and Chronic Obstructive Pulmonary Disease: A Case for Treatment
Proceedings of the ATS, April 1, 2005; 2(1): 12 - 19.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
R. Naeije
Pulmonary Hypertension and Right Heart Failure in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, April 1, 2005; 2(1): 20 - 22.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Cell Mol. Bio.Home page
J. L. Wright, H. Tai, and A. Churg
Cigarette Smoke Induces Persisting Increases of Vasoactive Mediators in Pulmonary Arteries
Am. J. Respir. Cell Mol. Biol., November 1, 2004; 31(5): 501 - 509.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
C.C. Christensen, M.S. Ryg, A. Edvardsen, and O.H. Skjonsberg
Relationship between exercise desaturation and pulmonary haemodynamics in COPD patients
Eur. Respir. J., October 1, 2004; 24(4): 580 - 586.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. Laghi, A. Jubran, A. Topeli, P. J. Fahey, E. R. Garrity Jr, D. J. de Pinto, and M. J. Tobin
Effect of Lung Volume Reduction Surgery on Diaphragmatic Neuromechanical Coupling At 2 Years
Chest, June 1, 2004; 125(6): 2188 - 2195.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J.L. Wright, S.G. Farmer, and A. Churg
A neutrophil elastase inhibitor reduces cigarette smoke-induced remodelling of lung vessels
Eur. Respir. J., July 1, 2003; 22(1): 77 - 81.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Laghi and M. J. Tobin
Disorders of the Respiratory Muscles
Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J.A. Barbera, V.I. Peinado, and S. Santos
Pulmonary hypertension in chronic obstructive pulmonary disease
Eur. Respir. J., May 1, 2003; 21(5): 892 - 905.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. M. Arcasoy, J. D. Christie, V. A. Ferrari, M. St. J. Sutton, D. A. Zisman, N. P. Blumenthal, A. Pochettino, and R. M. Kotloff
Echocardiographic Assessment of Pulmonary Hypertension in Patients with Advanced Lung Disease
Am. J. Respir. Crit. Care Med., March 1, 2003; 167(5): 735 - 740.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2002
Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 356 - 370.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
D. Chemla, V. Castelain, P. Herve, Y. Lecarpentier, and S. Brimioulle
Haemodynamic evaluation of pulmonary hypertension
Eur. Respir. J., November 1, 2002; 20(5): 1314 - 1331.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2002 American Thoracic Society 		  Work-Life