Relation between pulsus paradoxus and pulmonary function in patients with chronic airways obstruction

Area of Science:

• Pulmonology
• Cardiovascular Physiology

Background:

• Pulsus paradoxus, characterized by a drop in systolic blood pressure during inspiration, is a known clinical sign.
• Its specific relationship with chronic obstructive airway diseases (COADs) has not been well-established.
• Understanding this association may offer insights into disease pathophysiology.

Purpose of the Study:

• To investigate the prevalence and significance of pulsus paradoxus in patients with chronic, stable obstructive airway diseases.
• To explore the correlation between pulsus paradoxus and lung function parameters, specifically forced expiratory volume in 1 second (FEV1) and lung hyperinflation.

Main Methods:

• Observational study involving 68 patients diagnosed with chronic obstructive airway diseases and 14 healthy controls.
• Measurement of pulsus paradoxus during normal breathing.
• Assessment of lung function, including FEV1 and lung volumes to determine hyperinflation.

Main Results:

• Pulsus paradoxus was detected in 66% of patients with obstructive airway diseases, compared to none in healthy individuals.
• A significant correlation was found between pulsus paradoxus severity and reduced FEV1 in asthma patients.
• No correlation was observed between pulsus paradoxus and the degree of lung hyperinflation in any patient subgroup.

Conclusions:

• Pulsus paradoxus is a frequent finding in chronic obstructive airway diseases.
• While FEV1 correlates with pulsus paradoxus in asthma, lung hyperinflation does not appear to be the primary driver.
• Additional factors beyond hyperinflation likely contribute to the observed decrease in systolic pressure during lung inflation in these patients.