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Pulmonary diffusing capacity in left ventricular dysfunction.

J L Siegel1, A Miller, L K Brown

  • 1Division of Pulmonary and Critical Care Medicine, Mount Sinai School of Medicine, New York, New York.

Chest
|September 1, 1990
PubMed
Summary
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This study found that Diffusing capacity of the lungs for carbon monoxide (Dsb) effectively predicts congestive heart failure (CHF) in patients with left ventricular (LV) dysfunction. Dsb is particularly useful when lung rales are present, correlating with ejection fraction (EF).

Area of Science:

  • Pulmonary Medicine
  • Cardiology

Background:

  • Left ventricular (LV) dysfunction is a key feature of congestive heart failure (CHF).
  • Accurate assessment of LV dysfunction and its clinical manifestations is crucial for patient management.

Purpose of the Study:

  • To investigate the relationship between spirometry, Diffusing capacity of the lungs for carbon monoxide (Dsb), and left ventricular ejection fraction (EF) in patients diagnosed with CHF.
  • To determine if Dsb is a reliable indicator of heart failure severity and presence.

Main Methods:

  • Spirometry and Dsb measurements were conducted on 34 patients diagnosed with CHF and an EF < 40% developed.
  • Patients were analyzed both as a single group and stratified based on the presence or absence of pulmonary rales.

Main Results:

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  • Ejection fraction (EF) showed a significant correlation only with Dsb, not other spirometric values.
  • In patients with pulmonary rales, Dsb strongly correlated with EF.
  • Patients with rales exhibited significantly lower mean Dsb percent predicted compared to those without rales, despite similar mean EF.
  • Reduced Dsb was observed in most patients with rales (10/11), while it was normal in most patients without rales (21/23).

Conclusions:

  • Diffusing capacity of the lungs for carbon monoxide (Dsb) is a valuable predictor of clinically significant heart failure.
  • In patients with LV dysfunction, a normal Dsb suggests the absence of significant heart failure, whereas a diminished Dsb indicates its presence and severity, especially when pulmonary rales are detected.