Regional lung function in pulmonary hypertension

Utilizing 133-xenon gas and a scintillation camera, we examined the distributional relation between ventillation (V) and perfusion (Q) in patients with pulmonary hypertension (PH) comprising mitral stenosis (MS) and left to right shunt disease (shunt). In the case of MS, Q decreased at the dependent part of lung in proportion to the degree of PH, but preserved normal V and resulted in high V/Q value at this region, which was estimated to cause and physiological dead space effect on the gas exchange function. In the case of shunt disease, even with a high degree of PH, reduction of Q at the dependent lung region was not observed with normal preservation of V, thus obviating any type of the V/Q imbalance. Since the washout of xenon gas by resting tidal volume ventilation was observed to be delayed from the dependent lung region, latent ventilatory impairment in this region due to small airway closure at tidal breathing was also suspected.