Methacholine bronchial reactivity testing in patients with chronic congestive heart failure

To assess the role of bronchial hyperresponsiveness in chronic congestive heart failure (CHF), we performed standard methacholine bronchial provocation testing on nine patients with chronic CHF in New York Heart Association functional class 4. Mean pulmonary capillary wedge pressure and mean stroke volume index for the group at the time of study were 27 +/- 3 mm Hg and 27.9 +/- 8.9 ml/m2, respectively. Mean MMEFR was 71 percent of normal and mean delta to FEV1% was 76.3 percent. Only one patient, who was a 50-pack-year smoker, had a greater than 20 percent decrease in FEV1 with methacholine challenge, and this was at the highest concentration (25 mg/ml). We conclude that, in stable CHF, bronchial reactivity as assessed by standard methacholine challenge is not increased.