Airway Function in Healthy Subjects and Patients with Left Heart Disease

1975 ◽  
Vol 49 (3) ◽  
pp. 217-228 ◽  
Author(s):  
J. V. Collins ◽  
T. J. H. Clark ◽  
D. J. Brown
Keyword(s):  
Healthy Subjects ◽  
Vital Capacity ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Closing Volume ◽  
Forced Expiration ◽  
Left Heart ◽  
Airway Function ◽  
Significant Difference ◽  
Before And After

1. In forty non-smoking healthy subjects and seventy-two patients with left heart diseases measurements were made of the volume expired in the first second of a forced expiration (FEV1) and the total volume expired in a forced expiration (FVC) before and after inhalation of salbutamol. Before and after salbutamol the healthy subjects and patients also inhaled maximally an inspirate, the first part of which contained 133Xe and, during controlled expiration, the radioactivity of the expirate was measured and plotted against its volume. The resulting curves were divided into phases of different slope by eye, the point at which phase 3 changed to phase 4 being nominated the closing volume. 2. In forty non-smoking healthy subjects inhalation of salbutamol was followed by significant increase in FEV1 but FVC and closing volume did not change. 3. Change in posture from seated erect to supine in thirty of these healthy subjects was accompanied by significant reduction in FEV1 and FVC and as closing volume was not significantly different in the two positions the ratio closing volume/vital capacity was increased with recumbency. 4. In seventy-two patients with left heart diseases without a history of cough or wheeze, FEV1, FVC, closing volume and the ratio closing volume/vital capacity were significantly different from values in the healthy subjects. There was no significant difference between non-smokers and ex-smokers amongst the patients. 5. Significant increase in FEV1, FVC and reduction in closing volume and the ratio closing volume/vital capacity followed inhalation of salbutamol in patients with heart diseases but the values remained significantly different from those recorded in the healthy subjects. 6. In twenty patients with heart diseases, FEV1 and FVC were reduced by change in posture from seated erect to supine but the ratio closing volume/vital capacity and the regression with age of this ratio were not significantly changed by change in position. 7. In patients with heart diseases the ratio closing volume/vital capacity was significantly correlated with severity of breathlessness and length of symptom-history but not with left ventricular end-diastolic or pulmonary vein wedge pressures.

Deep breaths, methacholine, and airway narrowing in healthy and mild asthmatic subjects

2002 ◽  
Vol 93 (4) ◽  
pp. 1384-1390 ◽  
Author(s):  
Emanuele Crimi ◽  
Riccardo Pellegrino ◽  
Manlio Milanese ◽  
Vito Brusasco
Keyword(s):  
Forced Vital Capacity ◽  
Healthy Subjects ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Forced Expiration ◽  
Airway Narrowing ◽  
Significant Difference ◽  
Mild Asthmatic ◽  
Residual Capacity ◽  
Airway Conductance

Deep breaths taken before inhalation of methacholine attenuate the decrease in forced expiratory volume in 1 s and forced vital capacity in healthy but not in asthmatic subjects. We investigated whether this difference also exists by using measurements not preceded by full inflation, i.e., airway conductance, functional residual capacity, as well as flow and residual volume from partial forced expiration. We found that five deep breaths preceding a single dose of methacholine 1) transiently attenuated the decrements in forced expiratory volume in 1 s and forced vital capacity in healthy ( n = 8) but not in mild asthmatic ( n = 10) subjects and 2) increased the areas under the curve of changes in parameters not preceded by a full inflation over 40 min, during which further deep breaths were prohibited, without significant difference between healthy ( n = 6) and mild asthmatic ( n = 16) subjects. In conclusion, a series of deep breaths preceding methacholine inhalation significantly enhances bronchoconstrictor response similarly in mild asthmatic and healthy subjects but facilitates bronchodilatation on further full inflation in the latter.

Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population

2020 ◽  
Author(s):  
Koki Nakanishi ◽  
Masao Daimon ◽  
Yuriko Yoshida ◽  
Naoko Sawada ◽  
Kazutoshi Hirose ◽  
...  
Keyword(s):  
General Population ◽  
Subclinical Hypothyroidism ◽  
Left Atrial ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Left Heart ◽  
Ventricular Ejection Fraction ◽  
Significant Difference

Abstract Purpose Although subclinical hypothyroidism (SCH) is a common clinical entity and carries independent risk for incident heart failure (HF), its possible association with subclinical cardiac dysfunction is unclear. Left ventricular global longitudinal strain (LVGLS) and left atrial (LA) phasic strain can unmask subclinical left heart abnormalities and are excellent predictors for HF. This study aimed to investigate the association between the presence of SCH and subclinical left heart dysfunction in a sample of the general population without overt cardiac disease. Methods We examined 1078 participants who voluntarily underwent extensive cardiovascular health check-ups, including laboratory tests and 2-dimensional speckle-tracking echocardiography to assess LVGLS and LA reservoir, conduit, and pump strain. SCH was defined as an elevated serum thyroid-stimulating hormone level with normal concentration of free thyroxine. Results Mean age was 62 ± 12 years, and 56% were men. Seventy-eight (7.2%) participants exhibited SCH. Individuals with SCH had significantly reduced LA reservoir (37.1 ± 6.6% vs 39.1 ± 6.6%; P = 0.011) and conduit strain (17.3 ± 6.3% vs 19.3 ± 6.6%; P = 0.012) compared with those with euthyroidism, whereas there was no significant difference in left ventricular ejection fraction, LA volume index, LVGLS, and LA pump strain between the 2 groups. In multivariable analyses, SCH remained associated with impaired LA reservoir strain, independent of age, traditional cardiovascular risk factors, and pertinent laboratory and echocardiographic parameters. including LVGLS (standardized β −0.054; P = 0.032). Conclusions In an unselected community-based cohort, individuals with SCH had significantly impaired LA phasic function. This association may be involved in the higher incidence of HF in subjects with SCH.

scholarly journals P342 Left atrial contraction longitudinal strain is a volume-independet parameter

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Unlu ◽  
B Sezenoz ◽  
A Sahinarslan ◽  
T Arinsoy ◽  
A Cengel
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Reference Points ◽  
Volume Index ◽  
Valvular Heart Diseases ◽  
Wide Range ◽  
Before And After ◽  
2D Speckle Tracking

Abstract Background The left atrium (LA) is the main contributor of left ventricular (LV) filling. LA volume and volume index are routinely evaluated during echocardiographic assessment as having prognostic value in a wide range of cardiovascular pathologies. Yet, LA volume is easily affected by volume status. Thus, a non-invasive novel parameter such as indices of LA longitudinal strain (LS) have been proposed as alternative measurements. LA strain was shown to be associated with LV filling pressures and it has been suggested to provide prognostic information in patients with heart failure, atrial fibrillation, ischemic and valvular heart diseases. Nevertheless the acute effect of hemodynamic changes on LA LS indices is not well-established due to lack of evidence in healthy subjects and patient populations. The aim of this study is to evaluate the LA mechanics and change in echocardiographic methods used for assessment of LA by examining the end stage kidney patients before and after the hemodialysis (HD). Methods Patients between 18 and 85 years of age, receiving HD for at least 6 months were included. The echocardiographic images were obtained before and after HD. 2D speckle tracking strain analysis was performed for LA in 45 patients. Reference points for analysis are set on the "P" waves. LA reservoir, conduit and contraction phase LS were calculated. The changes in echocardiographic methods before and after hemodialysis were examined. Correlation between volume depletion and change in echocardiographic parameters were calculated. Results 45 patients (47.7 ± 14.7 years of age, 19 women) were included in study. The mean volume of ultrafiltration was 2755.12 ± 845.5 ml . The chamber sizes of LA are decreased after hemodialysis (LA diameter; 4.9 ± 0.8 cm vs. 4.4 ± 0.5 cm p < 0.001, LA area; 27.8 ± 4.0 cm2 vs. 19.6 ± 3.8 cm2 p < 0.001). LA reservoir phase LS measurements (% 44.6 ± 10.8 vs. % 38.15 ± 8.11 p < 0.001) showed significant changes after HD. In contrast LA contraction LS measurements (% -16.6 ± 7.0 vs. % -16.4 ± 7.1 p:0.893) did not differ after HD. The relative change in LA reservoir phase LS (r = 0.74, p:0.001) showed correlation with the ultrafiltrated volume. Conclusion LA contraction LS is a volume independent measurement obtained by 2D speckle tracking. Assessment of LA mechanics with echocardiography would be an easy and repeatable assessment which can guide to describe the cardiac pathophysiology and hemodynamics better. Moreover defining novel volume independent parameters for evaluation of LA would contribute to clinical perspectives of the patients.

Density dependence of maximal flow in dogs with central and peripheral obstruction

1983 ◽  
Vol 55 (3) ◽  
pp. 717-725 ◽  
Author(s):  
R. G. Castile ◽  
O. F. Pedersen ◽  
J. M. Drazen ◽  
R. H. Ingram
Keyword(s):  
Density Dependence ◽  
Vital Capacity ◽  
Forced Expiration ◽  
Flow Volume ◽  
Partial Obstruction ◽  
Volume Curve ◽  
Before And After ◽  
Lower Lung ◽  
Maximum Expiratory Flow ◽  
Flow Volume Curve

In 12 anesthetized, tracheotomized, vagotomized, open-chested, mongrel dogs we measured end and side hole airway pressures during forced expiration using a Pitot static probe. Volume was obtained as the integral of flow from a dog plethysmograph with frequency response adequate to 20 Hz. Equal pressure points (EPPs) and choke points (CPs) were located with dogs breathing air or a mixture of 80% helium-20% oxygen (HeO2) before and after partial obstruction of the trachea and intravenous histamine and propranolol. At 50% of vital capacity (VC) the CP was in the trachea in 11 of 12 dogs. Partial obstruction of the trachea decreased flow during the plateau of the maximum expiratory flow-volume curve (MEFVC) with the CP remaining in the trachea. The MEFVC plateau was extended to a lower lung volume. At 50% of VC the EPP moved downstream and density dependence remained high. Histamine and propranolol caused EPPs and CPs to move towards the periphery and density dependence to decrease. The shape of the MEFVC changed as the plateau was shortened and, in some instances, abolished. A plateau on the MEFVC could be regenerated by partial obstruction of the trachea. This was accompanied by return of the CP to the trachea and an increase in density dependence. Changes in density dependence were found to be a result of both the relocation of sites of flow limitation and differences in local CP areas with HeO2 and air.

Some Aspects of Pulmonary Function after Rapid Saline Infusion in Healthy Subjects

1973 ◽  
Vol 45 (3) ◽  
pp. 407-410 ◽  
Author(s):  
J. V. Collins ◽  
G. M. Cochrane ◽  
Jane Davis ◽  
S. R. Benatar ◽  
T. J. H. Clark
Keyword(s):  
Healthy Subjects ◽  
Dynamic Compliance ◽  
Upright Position ◽  
Closing Volume ◽  
Healthy Male ◽  
Static Compliance ◽  
Lung Volumes ◽  
Marked Individual ◽  
Before And After ◽  
Made In

1. Rapid intravenous (i.v.) infusions of saline were administered to five healthy male volunteers. Measurements were made of static and dynamic lung volumes, ‘closing volume’ and pulmonary compliance before and after infusion; all measurements were made in the seated upright position. 2. Following a 1 litre infusion small decreases occurred in static and dynamic lung volumes in all studies and were associated in each case with an increase in ‘closing volume’. ‘Closing volume’ returned to normal within 1 h of the infusion. 3. After 2 litre infusions more marked decreases in all lung volumes occurred and were associated with variable changes in ‘closing volume’. The pattern of change varied between individual subjects and this is thought to reflect differences in localization within the lungs of the effects of the saline load in different subjects. 4. After 2 litre infusions static compliance was decreased in all subjects during the first 10–15 min. Changes in dynamic compliance showed marked individual variation.

scholarly journals Comparison of Left-Heart Structure in Patients with Valvular and Nonvalvular Atrial Fibrillation at Haji Adam Malik Hospital Medan

2020 ◽  
Vol 6 (2) ◽  
pp. 104-110
Author(s):  
Rizki Astria Farindani ◽  
Abdullah Afif Siregar ◽  
Cut Aryfa Andra ◽  
Harris Hasan ◽  
Zulfikri Mukhtar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Artery ◽  
Heart Diseases ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Left Heart ◽  
Nonvalvular Atrial Fibrillation ◽  
Ventricular Geometry ◽  
Heart Chamber ◽  
Valvular Heart Diseases

Background: Atrial fibrillation is still a most common arrhythmia. The incidence increases according to each remodeling of the heart chamber. Valvular and non valvular heart diseases have differences in hemodynamic adaptations that trigger a certain remodeling. However, until now it is not known whether there is a difference between the left heart structure and valvular and non valvular atrial fibrillation. Method: There were 60 patients with atrial fibrillation hospitalized from August 2018 to December 2018. The samples were then divided into 2 groups, namely the valvular and non valvular groups, each with 30 samples. All samples that met the criteria underwent echocardiography. Then comparative statistics were carried out with p values ​​<0.05 said to be statistically significant. Results: In this study we found that coronary heart disease (CHD) was the most common etiology in the non valvular group (73.2%), whereas mitral stenosis was common in the non valvular group (67.7%). In this study there were no differences in left ventricular geometry in the two groups (p = 0.278). There were significant differences in left atrial diameter between the two groups (p = 0.0001). There were significant differences in pulmonary artery diameter between the two groups in this study (p = 0.0001). Conclusion: There was no difference in the left ventricular geometry, but there were differences in the diameter of the left atrium and the diameter of the pulmonary artery.

scholarly journals Myonecrosis in Aortic Valvular Heart Diseases

2009 ◽  
Vol 13 (Number 2) ◽  
pp. 9-12
Author(s):  
Md. Khalequzzaman ◽  
M A Islam ◽  
Md. O Hoque ◽  
M Ferdous ◽  
A H K Chowdhury ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Heart Diseases ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Definitive Treatment ◽  
Control Group ◽  
Cross Sectional ◽  
Valvular Heart Diseases ◽  
Significant Difference ◽  
Venous Sample

This cross sectional study was done among 20 patients with aortic stenosis and 20 healthy controls to evaluate the association of cardiac specific troponin 1 (ant) and sonic valvular heart diseases. The study was conducted in °militant, department in National laminae of Cardiovascular Diseases (N1CVD.)A structured queslionilaire and checklist was used to collect data through face to face interview. Color dapple, echocarchiognsphy was done and 5 ml of venous sample was dmwo from each subjects and laboratory estimation of an, was done. The arid in control group and sonic stenosis patients showed significant difference in mean (<0.001). ant level in aortic stenosis patients increases in the absence of heart failure indicating that it can expose the cardiotnyocnes to injury prior to development of oven left ventricular dysftinction. So. serial monitoring of aid may help clinicians to give definitive treatment (reface development af complications.

scholarly journals PENGARUH LATIHAN AEROBIK TERHADAP FORCED VITAL CAPACITY (FVC)PRIA DEWASA DENGANOVERWEIGHT

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Ester Florencia Sagay ◽  
Hedison Polii ◽  
Herlina I. S. Wungouw
Keyword(s):  
Aerobic Exercise ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Sampling Technique ◽  
Mean Value ◽  
Average Value ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
The Mean

Abstract: Changes to respiratory function due to regular aerobic exercise will affect the value of pulmonary function, especially in Forced Vital Capacity (FVC). This research aimed to determine the effect of aerobic exercise on FVC overweight male students of Unsrat Medical Faculty. This research is analytic with design experimental, one group pre and post test design. The sampling technique used is non-purposive sampling technique. The research sample was taken from the students of the Faculty of Medicine 2009, Univercity of Sam Ratulangi who fulfill the inclusion criteria. Some 32 students were selected as research subjects. After giving informed consent, FVC measurement was done with the spirometer. After it was measured, they were given treatmen in the form aerobic exercise using a stationary bike for three weeks with frequency of exercise three times a week and exercise intensity for 30 minutes. We measured again FVC values after the exercise three times program. Normality test data showed significance for FVC value before treatment by 0.752, and after treatment by 0.912. Comparison of the average value before and after exercise were tested by using a paired test. Significant value for FVC is P = 0.084, means there is no significant difference between FVC values before and after exercise (P> 0.05). The mean FVC was 3.88 before treatment and after treatment the mean value was 4.00, an increase in the average value of 0.11. Conclusion:Aerobic Exercise on a regular basis using a stationary bike on the overweight male student can improve lung function in particular the mean FVC but there was no significant difference from the mean value. Keywords: FVC, Aerobic Exercise, Overweight.   Abstrak: Perubahan fungsi pernapasan karena latihan aerobik secara teratur akan mempengaruhi nilai fungsi paru khususnya Forced Vital Capacity (FVC). Penelitian ini untuk mengetahui pengaruh latihan aerobik terhadap FVC mahasiswa pria Fakultas Kedokteran Unsrat dengan berat badan lebih.Penelitian ini bersifat analitik dengan rancangan eksperimental one grup pre and post test design. Pengambilan sampel dilakukan dengan teknik non purposive sampling. Sampel penelitian diambil dari Mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Angkatan 2009.Sejumlah 32 orang mahasiswa terpilih sebagai subjek penelitian dan dilakukan pengukuran FVC dengan Spirometer.Setelah itu diberikan perlakuan berupa latihan aerobik menggunakan sepeda statis selama tiga minggu dengan frekuensi latihan tiga kali seminggu dan intensitas latihan selama 30 menit.Selanjutnya dilakukan pengukuran kembali nilai FVC sesudah program latihan.Uji normalitas data menunjukkan nilai signifikansi untuk FVC sebelum perlakuan sebesar 0.752, dan sesudah perlakuan sebesar 0.912. Perbandingan nilai rata  rata  sebelum dan sesudah latihan diuji dengan menggunakan uji t berpasangan.Nilai signifikan untuk FVC adalah P = 0.084, berarti tidak terdapat perbedaan yang bermakna antara nilai FVC sebelum dan sesudah latihan (P > 0.05) .Nilai rerata FVC sebelum pelakuan adalah 3,88  dan nilai rerata sesudah perlakuan adalah  4,00,  terjadi penigkatan nilai rerata sebesar 0,11.Simpulan:Latihan Aerobik menggunakan sepeda statis secara teratur dapat meningkatkan nilai rerata fungsi paru khususnya FVC tetapi tidak terdapat perbedaan yang bermakna dari nilai rerata tersebut. Kata Kunci: FVC, Latihan Aerobik, Berat Badan Lebih (Overweight).

Abstract 251: Comparison of Ischemia-Reperfusion Injury in Langendorff-Prepared Hearts From Zucker Diabetic Fatty and Lean Rats

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
William J Cleveland ◽  
Claudius Balzer ◽  
Michele M Salzman ◽  
Matthias L Riess
Keyword(s):  
Ischemia Reperfusion Injury ◽  
Heart Function ◽  
Ischemia Reperfusion ◽  
Left Ventricular Pressure ◽  
Left Ventricular ◽  
Zdf Rat ◽  
Mitochondrial Redox State ◽  
Significant Difference ◽  
Before And After ◽  
Zdf Rats

Introduction: The Zucker Diabetic Fatty (ZDF) rat is a relevant model for assessing ischemia-reperfusion (IR) injury, due to it having comorbidities associated with a higher risk for cardiac arrest and poorer outcomes following cardiopulmonary resuscitation in humans. Hypothesis: Based on previous studies in the literature, we hypothesize that ZDF rats would have similar outcomes to lean rats subjected to IR when accounting for perfusion buffer osmolarity. Methods: ZDF (n=4) and lean control (n=6) rats were anesthetized with pentobarbital, intubated, and mechanically ventilated and monitored for 3-hours, with blood glucose (BG) readings taken before and after ventilation. They were then decapitated and a thoracotomy performed to isolate the Langendorff-prepared hearts. Krebs buffer with the osmolarity adjusted to each rat’s BG level using glucose was used to perfuse the hearts. Following a 20-minute stabilization period, the hearts were subjected to a 30-minute period of global no-flow ischemia followed by 120-minutes of reperfusion. Spontaneous heart rate, isovolumetric left ventricular pressure (LVP), and mitochondrial redox state were measured continuously. Data are mean ± SD. Statistics: two-tailed t-test, p<0.05 Results: There was no significant difference in average body weight between the two groups; however, ZDF rats showed significantly higher BG levels (504±52 vs 174±14 mg/dl) than their lean littermates. ZDF rats had a greater percent change from baseline systolic LVP upon reperfusion than lean rats (133±33.3 vs 84.9±16.5 %), with the lean rats never returning to baseline. Diastolic contracture occurred more in lean rats during ischemia, but trended towards a lower contracture during reperfusion. No significant difference was seen in developed LVP, rate pressure products, or mitochondrial redox states, although lean rats trended towards better diastolic contractility and relaxation. Conclusion: Lean rats showed marginally better outcomes in heart function than their ZDF littermates. Future studies will focus on potential mechanisms of Type 2 diabetes that may exacerbate IR injuries.

Dynamic airway function during exercise in COPD assessed via impulse oscillometry before and after inhaled bronchodilators.

2021 ◽  
Author(s):  
Nicholas B. Tiller ◽  
Min Cao ◽  
Fang Lin ◽  
Wei Yuan ◽  
Chu-yi Wang ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Airway Resistance ◽  
Pulmonary Ventilation ◽  
Peak Exercise ◽  
Impulse Oscillometry ◽  
Airway Function ◽  
Volume Curve ◽  
Copd Patients ◽  
Before And After ◽  
Flow Volume Curve

Introduction. Assessing airway function during exercise provides useful information regarding mechanical properties of the airways and extent of ventilatory limitation in COPD. The primary aim of this study was to use impulse oscillometry (IOS) to assess dynamic changes in airway impedance across a range of exercise intensities in GOLD 1-4 patients, before and after albuterol. A secondary aim was to assess reproducibility of IOS measures during exercise. Methods. Fifteen COPD patients (8 male; age=66±8 y; pre-bronchodilator FEV1=54.3±23.6%Pred) performed incremental cycle ergometry before and 90-min after inhaled albuterol. Pulmonary ventilation and gas exchange were measured continuously, and IOS-derived indices of airway impedance were measured every 2 min immediately preceding inspiratory capacity manoeuvres. Test-retest reproducibility of exercise IOS was assessed as mean difference between replicate tests in five healthy subjects (3 male). Results. At rest and during exercise, albuterol significantly increased airway reactance (X5), and decreased airway resistance (R5, R5-20), impedance (Z5), and end-expiratory lung volume (60±12 vs. 58±12%TLC, main effect p=0.003). At peak exercise, there were moderate-to-strong associations between IOS variables and IC, and between IOS and concavity in the expiratory limb of the flow-volume curve. Exercise IOS exhibited moderate reproducibility in healthy subjects which was strongest with R5 (mean diff. -0.01±0.05 kPa/L/s; ICC=0.68), R5-20 (mean diff. -0.004±0.028 kPa/L/s; ICC=0.65), and Z5 (mean diff. -0.006±0.021 kPa/L/s; ICC=0.69). Conclusions. Exercise evoked increases in airway resistance and decreases in reactance that were ameliorated by inhaled bronchodilators. The technique of exercise IOS may aid in the clinical assessment of dynamic airway function during exercise.

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