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Related Experiment Videos

Augmented ventilatory response to exercise in pulmonary hypertension.

J Theodore, E D Robin, A J Morris

    Chest
    |January 1, 1986
    PubMed
    Summary

    Patients with pulmonary hypertension exhibit an increased ventilatory response to exercise. Heart-lung transplantation normalizes this response, suggesting a neural basis for the augmented breathing in pulmonary hypertension.

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    Area of Science:

    • Cardiopulmonary Physiology
    • Exercise Physiology
    • Transplantation Medicine

    Background:

    • Pulmonary hypertension is associated with an abnormal ventilatory response during exercise.
    • The underlying mechanisms of this augmented ventilation are not fully understood.
    • Investigating the ventilatory response can provide insights into cardiopulmonary regulation.

    Purpose of the Study:

    • To assess the ventilatory response to submaximal exercise in patients with pulmonary hypertension.
    • To evaluate the impact of heart-lung transplantation and heart transplantation on this response.
    • To explore the relationship between ventilatory response and chemical modulators of breathing.

    Main Methods:

    • Determined the slope of minute ventilation over carbon dioxide production (VE/VCO2) during submaximal exercise.

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  • Studied normal subjects, patients with pulmonary hypertension (pre- and post-transplant), and heart transplant recipients.
  • Analyzed arterial blood gases (pH, PaCO2, PaO2) to correlate with ventilatory drive.

    • Main Results:

    • Patients with pulmonary hypertension showed a significantly augmented VE/VCO2 slope compared to normal subjects.
    • Heart-lung transplantation normalized the VE/VCO2 slope to levels comparable to normal subjects.
    • Heart transplantation also resulted in a normal VE/VCO2 slope, similar to normal and post-heart-lung transplant groups.
    • The augmented ventilatory response in pulmonary hypertension did not correlate with arterial pH, PaCO2, or PaO2.

    Conclusions:

    • Pulmonary hypertension may involve an augmented neural drive to breathe during exercise, possibly from pulmonary afferents.
    • The denervated lung after transplantation preserves normal ventilatory regulation during exercise, suggesting pulmonary afferents are not critical in normal subjects.
    • VE/VCO2 slope measurement during exercise may serve as a noninvasive screening tool for pulmonary hypertension.