Impaired pulmonary gas exchange efficiency, but normal pulmonary artery pressure increases, with hypoxia in men and women with a patent foramen ovale

2020 ◽  
Vol 105 (9) ◽  
pp. 1648-1659
Author(s):  
Joseph W. Duke ◽  
Kara M. Beasley ◽  
Julia P. Speros ◽  
Jonathan E. Elliott ◽  
Steven S. Laurie ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Patent Foramen Ovale ◽  
Pulmonary Gas Exchange ◽  
Foramen Ovale ◽  
Men And Women ◽  
Artery Pressure

scholarly journals Effect of a patent foramen ovale on pulmonary gas exchange efficiency at rest and during exercise

2011 ◽  
Vol 110 (5) ◽  
pp. 1354-1361 ◽  
Author(s):  
Andrew T. Lovering ◽  
Michael K. Stickland ◽  
Markus Amann ◽  
Matthew J. O'Brien ◽  
John S. Hokanson ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Patent Foramen Ovale ◽  
Arterial Oxygen Saturation ◽  
Pulmonary Gas Exchange ◽  
Arterial Oxygen ◽  
Foramen Ovale ◽  
Healthy Humans ◽  
Significant Difference ◽  
Ergometer Exercise ◽  
Exchange Inefficiency

The prevalence of a patent foramen ovale (PFO) is ∼30%, and this source of right-to-left shunt could result in greater pulmonary gas exchange impairment at rest and during exercise. The aim of this work was to determine if individuals with an asymptomatic PFO (PFO+) have greater pulmonary gas exchange inefficiency at rest and during exercise than subjects without a PFO (PFO−). Separated by 1 h of rest, 8 PFO+ and 8 PFO− subjects performed two incremental cycle ergometer exercise tests to voluntary exhaustion while breathing either room air or hypoxic gas [fraction of inspired O2 (FiO2) = 0.12]. Using echocardiography, we detected small, intermittent boluses of saline contrast bubbles entering directly into the left atrium within 3 heart beats at rest and during both exercise conditions in PFO+. These findings suggest a qualitatively small intracardiac shunt at rest and during exercise in PFO+. The alveolar-to-arterial oxygen difference (AaDo2) was significantly ( P < 0.05) different between PFO+ and PFO− in normoxia (5.9 ± 5.1 vs. 0.5 ± 3.5 mmHg) and hypoxia (10.1 ± 5.9 vs. 4.1 ± 3.1 mmHg) at rest, but not during exercise. However, arterial oxygen saturation was significantly different between PFO+ and PFO− at peak exercise in normoxia (94.3 ± 0.9 vs. 95.8 ± 1.0%) as a result of a significant difference in esophageal temperature (38.4 ± 0.3 vs. 38.0 ± 0.3°C). An asymptomatic PFO contributes to pulmonary gas exchange inefficiency at rest but not during exercise in healthy humans and therefore does not explain intersubject variability in the AaDo2 at maximal exercise.

scholarly journals Pulmonary Artery Pressure and Alveolar Gas Exchange in Man during Acclimatization to 12,470 ft

1971 ◽  
Vol 50 (4) ◽  
pp. 827-837 ◽  
Author(s):  
Richard S. Kronenberg ◽  
Peter Safar ◽  
Joseph Lee ◽  
Fred Wright ◽  
William Noble ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Artery Pressure ◽  
Alveolar Gas Exchange

scholarly journals Long term effects of non-invasive mechanical ventilation on pulmonary haemodynamics in patients with chronic respiratory failure

Thorax ◽  
2001 ◽  
Vol 56 (7) ◽  
pp. 524-528
Author(s):  
B Schönhofer ◽  
T Barchfeld ◽  
M Wenzel ◽  
D Köhler
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Gas Exchange ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Chronic Respiratory Failure ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure ◽  
Pulmonary Haemodynamics

BACKGROUNDIt is not known whether long term nocturnal mechanical ventilation (NMV) reduces pulmonary hypertension in patients with chronic respiratory failure (CRF).METHODSPulmonary haemodynamics, spirometric values, and gas exchange were studied in 33 patients requiring NMV due to CRF (20 with thoracic restriction, 13 with chronic obstructive pulmonary disease (COPD)) at baseline and after 1 year of NMV given in the volume cycled mode. Patients with COPD also received supplemental oxygen.RESULTSLong term NMV improved gas exchange while lung function remained unchanged. Mean pulmonary artery pressure at rest before NMV was higher in patients with thoracic restriction than in those with COPD (33 (10) mm Hgv 25 (6) mm Hg). After 1 year of NMV mean pulmonary artery pressure decreased in patients with thoracic restriction to 25 (6) mm Hg (mean change –8.5 mm Hg (95% CI –12.6 to –4.3), p<0.01) but did not change significantly in patients with COPD (mean change 2.2 mm Hg (95% CI –0.3 to 4.8)).CONCLUSIONSLong term NMV in CRF improves pulmonary haemodynamics in patients with thoracic restriction but not in patients with COPD.

AltitudeOmics: impaired pulmonary gas exchange efficiency and blunted ventilatory acclimatization in humans with patent foramen ovale after 16 days at 5,260 m

2015 ◽  
Vol 118 (9) ◽  
pp. 1100-1112 ◽  
Author(s):  
Jonathan E. Elliott ◽  
Steven S. Laurie ◽  
Julia P. Kern ◽  
Kara M. Beasley ◽  
Randall D. Goodman ◽  
...  
Keyword(s):  
Gas Exchange ◽  
High Altitude ◽  
Sea Level ◽  
Patent Foramen Ovale ◽  
Acute Mountain Sickness ◽  
Cycle Ergometer ◽  
Pulmonary Gas Exchange ◽  
Foramen Ovale ◽  
Ergometer Exercise ◽  
High Altitude Acclimatization

A patent foramen ovale (PFO), present in ∼40% of the general population, is a potential source of right-to-left shunt that can impair pulmonary gas exchange efficiency [i.e., increase the alveolar-to-arterial Po2 difference (A-aDO2)]. Prior studies investigating human acclimatization to high-altitude with A-aDO2 as a key parameter have not investigated differences between subjects with (PFO+) or without a PFO (PFO−). We hypothesized that in PFO+ subjects A-aDO2 would not improve (i.e., decrease) after acclimatization to high altitude compared with PFO− subjects. Twenty-one (11 PFO+) healthy sea-level residents were studied at rest and during cycle ergometer exercise at the highest iso-workload achieved at sea level (SL), after acute transport to 5,260 m (ALT1), and again at 5,260 m after 16 days of high-altitude acclimatization (ALT16). In contrast to PFO− subjects, PFO+ subjects had 1) no improvement in A-aDO2 at rest and during exercise at ALT16 compared with ALT1, 2) no significant increase in resting alveolar ventilation, or alveolar Po2, at ALT16 compared with ALT1, and consequently had 3) an increased arterial Pco2 and decreased arterial Po2 and arterial O2 saturation at rest at ALT16. Furthermore, PFO+ subjects had an increased incidence of acute mountain sickness (AMS) at ALT1 concomitant with significantly lower peripheral O2 saturation (SpO2). These data suggest that PFO+ subjects have increased susceptibility to AMS when not taking prophylactic treatments, that right-to-left shunt through a PFO impairs pulmonary gas exchange efficiency even after acclimatization to high altitude, and that PFO+ subjects have blunted ventilatory acclimatization after 16 days at altitude compared with PFO− subjects.

scholarly journals The effects of patent foramen ovale (PFO) on pulmonary gas exchange during incremental exercise

2008 ◽  
Vol 22 (S1) ◽  
Author(s):  
Andrew Thomas Lovering ◽  
Michael K. Stickland ◽  
Markus Amann ◽  
Joan C. Murphy ◽  
John S. Hokanson ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Patent Foramen Ovale ◽  
Pulmonary Gas Exchange ◽  
Incremental Exercise ◽  
Foramen Ovale

scholarly journals The Effect of Riociguat on Gas Exchange, Exercise Performance, and Pulmonary Artery Pressure During Acute Altitude Exposure

2016 ◽  
Vol 27 (3) ◽  
pp. 428 ◽  
Author(s):  
Jon Andrews ◽  
Stefanie Martina ◽  
Michael Natoli ◽  
Nicole Harlan ◽  
Luke Neilans ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Exercise Performance ◽  
Artery Pressure ◽  
Altitude Exposure
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