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Bronchial hyperreactivity in patients with mitral valve disease
Y Nishimura1, H Maeda, M Yokoyama
1First Department of Internal Medicine, Kobe University School of Medicine, Japan.
Chest
|November 1, 1990
Summary
Chronic heart failure patients with mitral valve disease exhibit significant bronchial hyperreactivity (BHR). This BHR, linked to airway narrowing, persists even after mitral valve replacement surgery.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Respiratory Physiology
Background:
- Chronic heart failure (CHF) is often associated with respiratory complications.
- Bronchial hyperreactivity (BHR) is a condition characterized by exaggerated bronchoconstrictor responses.
Purpose of the Study:
- To investigate the mechanism of BHR in patients with chronic heart failure due to mitral valve disease (MVD).
- To assess the impact of mitral valve replacement (MVR) on BHR in MVD patients.
Main Methods:
- Methacholine inhalation challenge tests were performed.
- Pulmonary function tests, including Vmax25, were conducted.
- Cardiac catheterization measured pulmonary artery pressures.
Main Results:
- 16 out of 19 MVD patients showed significant BHR compared to controls.
- Maximal expiratory flow at 25% vital capacity (Vmax25) correlated with BHR severity (PD35Grs) and symptom duration.
- BHR severity (log PD35Grs) correlated with pulmonary artery wedge pressure.
- MVR improved BHR parameters, but BHR persisted in most patients.
Conclusions:
- Long-term MVD is associated with significant BHR.
- BHR in MVD is linked to peripheral airway narrowing and remodeling, potentially exacerbated by pulmonary congestion.
- Mitral valve replacement does not fully resolve BHR in MVD patients.