Bronchial Hyperresponsiveness in Patients with Chronic Congestive Heart Failure: RESULTS
The baseline pulmonary function test results are shown in Table 1 and Figure 1. Each mean value for age, FVC, FEV1 and Zrs at 3 Hz did not statistically differ among the groups. The AFEV, in group 1 (0.19 ±0.18 mg/ml) was lower than that in group 2 (0.48 ±0.24 mg/ml; p<0.05 by Student Mest).
The hemodynamic variables are shown in Table 2. The mean values for HR and CTR in group 2a were higher than those in group 1. The mean values for mPAP, mPCWP, and CTR in group 2b were also higher than those in group 1 (p<0.05). The mean values for LVEF in groups 2a and 2b were lower than that in group 1 (P<0.05). There were no statistical differences in LVEF between group 2a and group 2b.
FIGURE 1. Values for FVC and FEV, in individual subjects. Mean values for FVC and FEV, did not differ among the groups.
Table 1—General Characteristics and Baseline Pulmonary Function Test Results
|
Data |
Group 1 |
Group 2a |
Group 2b |
|
No. of patients |
18 |
18 |
15 |
|
Sex |
7M; 11F |
7M; 11F |
10M; 5F |
|
Age, yr |
61 ±8 |
60± 15 |
62 ±7 |
|
FVC, L |
2.52 ±0.62 |
2.41 ±0.72 |
2.62 ±0.77 |
|
FEV,, L |
1.97 ±0.45 |
1.86 ±0.57 |
1.92 ±0.56 |
|
Zrs, cm H20/L/sec |
4.4± 1.0 |
4.4± 1.3 |
4.2± 1.3 |
|
AFEV,, L |
0.19±0.18f |
0.47 ±0.23 |
0.50 ±0.25 |
Figure 2 shows the PC20-FEV, value of individual patients. The median value for PC20-FEV, in group 1 (>20 mg/ml) was significantly higher than that in group 2a (5.29 mg/ml) and that in group 2b (5.74 mg/ ml) (p<0.05 by the Mann-Whitney U-test), but there was no difference in PC20-FEV! between group 2a and group 2b.
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FIGURE 2. Values for PC20-FEV, in individual subjects. Arrows indicate median value of each group. Median values of PC20-FEV, in group 2a and group 2b were significantly lower than that for group 1.
Table 2—Hemodynamic Variables by Cardiac Catheterization and Chest Roentgenogram
|
Data |
Group 1 |
Group 2a |
Group 2b |
|
|
HR, beats |
|
|
|
|
|
per min |
66 ±13 (9) |
85 ±13 (15)t |
79 ±22 |
(15) |
|
Mean arterial |
|
|
|
|
|
pressure, mm Hg |
94 ±15 (9) |
90 ±10 (15) |
98 ± 21 |
(15) |
|
mPAP, mm Hg |
15 ±3 (8) |
19 ±7 (15) |
26 ±13 |
(15)t |
|
mPCWP, mm Hg |
10 ±2 (8) |
12 ±6 (15) |
18 ±10 |
(15)t |
|
CI, L/min/m2 |
2.7 ±0.4 (7) |
3.0±0.7 (15) |
2.7±0.7 |
‘ (15) |
|
LVEF |
65 ±11 (8) |
47 ±15 (12)$ |
50± 14 |
(И)Ф |
|
LVEDP, mm Hg |
16 ±7 (8) |
14 ±10 (12) |
23± 13 |
(10) |
|
CTR, percent |
54 ±6 (18) |
58 ±6 (18)t |
59 ±6 (15)t |
|
Figure 3 shows PC20-FEV1 values for nonsmokers and ex-smokers. The median value for PC20-FEVi in ex-smokers (>20 mg/ml) was not different statistically from that in nonsmokers (12.1 mg/ml).
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FIGURE 3. Values for PC20-FEV, in nonsmokers and ex-smokers. Median value (arrow) for PC20-FEV, in ex-smokers (>20 mg/ml) was not different statistically from that (arrow) in nonsmokers (12.1 mg/ml).
The relationship between hemodynamic variables and PC20-FEV! are presented in Figure 4. None of these variables was significantly correlated with PC20- FEV1.
FIGURE 4. Correlation between PC20- FEV, and hemodynamic variables. Cor¬relation coefficients were calculated by using Spearman’s rank method. None of variables were correlated with PC20- FEV1.
Figure 5 shows the relationship between etiologies of congestive heart failure and PC20-FEV, in group 2. All patients with hypertensive heart disease had increased bronchial responsiveness (PC20-FEV1 <10 mg/ml), but the median value for PC20-FEV, did not statistically differ among the groups.
FIGURE 5. Values for PC20-FEV, in various etiologies of congestive heart failure in group 2. Arrows indicate median value of each group. Differences were not significant among groups.
