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Respiratory function in precapillary pulmonary hypertension

A M Romano1, S Tomaselli, G Gualtieri

  • 1Division of Pneumology, I.R.C.C.S Policlinico San Matteo, Pavia, Italy.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|January 1, 1993
PubMed
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Pulmonary hypertension patients often show mild lung function abnormalities, including severe drops in oxygen saturation during exercise. Suspect pulmonary hypertension in breathless patients with normal chest X-rays and basic lung function tests.

Area of Science:

  • Cardiology
  • Pulmonology
  • Respiratory Medicine

Background:

  • Dyspnoea on exertion is a primary symptom of precapillary pulmonary hypertension (PPH).
  • Patients with PPH, including idiopathic pulmonary hypertension (IPH) and chronic thromboembolic pulmonary hypertension (CTEPH), are often initially evaluated in pulmonary function laboratories.

Purpose of the Study:

  • To analyze pulmonary function test results in patients diagnosed with PPH.
  • To identify characteristic pulmonary function patterns in different types of PPH, including IPH, CTEPH, and Eisenmenger physiology.

Main Methods:

  • Retrospective study of 34 PPH patients (1987-1992) from 5,467 initial laboratory attendees.
  • Evaluation of respiratory function, blood gases, arterial oxyhaemoglobin saturation (HbSaO2) during exercise, diffusing capacity of the lungs for carbon monoxide (DLCO), and shunt fraction (QS%).

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  • Comparison of pulmonary function between IPH, CTEPH, and Eisenmenger physiology groups.

    • Main Results:

    • No obstructive defects were observed in IPH and CTEPH groups; mild restrictive defects in 20% of subjects.
    • Typical findings included normal lung volumes, normal/slightly reduced DLCO, mild hypoxemia with hypocapnia, severe HbSaO2 drops during exercise, and pathological QS%.
    • More severe functional impairment was noted in the Eisenmenger physiology group.

    Conclusions:

    • Pulmonary hypertension should be suspected in patients with exertional dyspnoea, normal chest X-rays, and normal respiratory function tests, warranting specific invasive testing.
    • The distinct functional profile in Eisenmenger physiology may relate to disease stage or underlying mechanisms.