The alveolar-capillary membrane diffusing capacity and the pulmonary capillary blood volume in heart transplant candidates

O. A. Al-Rawas, R. Carter, R. D. Stevenson, S. K. Naik, D. J. Wheatley

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives - To determine the mechanism of impairment of pulmonary transfer factor for carbon monoxide (TL(CO)) in heart transplant candidates, as this is the most common lung function abnormality. Setting - Regional cardiopulmonary transplant centre. Methods - TL(CO) and its components (the diffusing capacity of the alveolar-capillary membrane (D(M)) and the pulmonary capillary blood volume (V(C))) were measured using the Roughton and Forster method and the single breath technique in 38 patients with severe chronic heart failure awaiting heart transplantation (mean age 51 years, range 19 to 61; mean left ventricular ejection fraction 12.8%). Results were compared with data from 26 normal subjects (mean age 47 years, range 27 to 62). Results - Mean per cent predicted TL(CO), D(M), and V(C) were significantly reduced in patients (69.9%, 81.4%, and 80.2% of predicted, respectively) compared with controls (97.7%, 100.1%, and 102.3% of predicted, respectively, p < 0.001). The relative contribution of the two components of TL(CO) in patients was similar to that of normal subjects, with each component accounting for approximately 50% of the total resistance to diffusion (1/TL(CO)). Conclusions - TL(CO) impairment in patients with severe chronic heart failure awaiting heart transplantation results from a proportionate reduction in both D(M) and V(C), suggesting a significant disturbance of the pulmonary vascular bed.

Original languageEnglish
Pages (from-to)156-160
Number of pages5
JournalHeart
Volume83
Issue number2
Publication statusPublished - 2000

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Pulmonary Diffusing Capacity
Blood Volume
Transplants
Lung
Membranes
Heart Transplantation
Heart Failure
Transfer Factor
Carbon Monoxide
Stroke Volume
Blood Vessels

Keywords

  • Diffusing capacity
  • Heart failure
  • Pulmonary capillary blood volume
  • Pulmonary transfer factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The alveolar-capillary membrane diffusing capacity and the pulmonary capillary blood volume in heart transplant candidates. / Al-Rawas, O. A.; Carter, R.; Stevenson, R. D.; Naik, S. K.; Wheatley, D. J.

In: Heart, Vol. 83, No. 2, 2000, p. 156-160.

Research output: Contribution to journalArticle

Al-Rawas, O. A. ; Carter, R. ; Stevenson, R. D. ; Naik, S. K. ; Wheatley, D. J. / The alveolar-capillary membrane diffusing capacity and the pulmonary capillary blood volume in heart transplant candidates. In: Heart. 2000 ; Vol. 83, No. 2. pp. 156-160.
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AB - Objectives - To determine the mechanism of impairment of pulmonary transfer factor for carbon monoxide (TL(CO)) in heart transplant candidates, as this is the most common lung function abnormality. Setting - Regional cardiopulmonary transplant centre. Methods - TL(CO) and its components (the diffusing capacity of the alveolar-capillary membrane (D(M)) and the pulmonary capillary blood volume (V(C))) were measured using the Roughton and Forster method and the single breath technique in 38 patients with severe chronic heart failure awaiting heart transplantation (mean age 51 years, range 19 to 61; mean left ventricular ejection fraction 12.8%). Results were compared with data from 26 normal subjects (mean age 47 years, range 27 to 62). Results - Mean per cent predicted TL(CO), D(M), and V(C) were significantly reduced in patients (69.9%, 81.4%, and 80.2% of predicted, respectively) compared with controls (97.7%, 100.1%, and 102.3% of predicted, respectively, p < 0.001). The relative contribution of the two components of TL(CO) in patients was similar to that of normal subjects, with each component accounting for approximately 50% of the total resistance to diffusion (1/TL(CO)). Conclusions - TL(CO) impairment in patients with severe chronic heart failure awaiting heart transplantation results from a proportionate reduction in both D(M) and V(C), suggesting a significant disturbance of the pulmonary vascular bed.

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