Roy H. Behnke

Left ventricular function in patients with chronic obstructive pulmonary disease

Left ventricular function was assessed in six patients with essentially normal cardiopulmonary function, in five patients with primary myocardial disease, and in 16 patients with chronic obstructive pulmonary disease by determining the response of the ventricle to an increased resistance to ejection. Studies were performed at the time of cardiac catheterization and increased resistance to left ventricular ejection was produced by the intravenous infusion of methoxamine. In the control patients, methoxamine produced an increase in stroke volume index (SVI), in stroke work index (SWI), and stroke power index (SPI), whereas left ventricular end-diastolic pressure (LVEDP) increased only moderately. In contrast SVI, SWI, and SPI fell, whereas LVEDP increased inordinately in the patients with myocardiopathy. The patients with chronic obstructive pulmonary disease responded to the infusion with an increase in SVI, SWI, SPI, and LVEDP comparable to the control patients. Furthermore, in this latter group of patients, a quantitatively similar response was observed in those with essentially normal resting hemodynamics, in those with resting pulmonary hypertension, and in those whose disease had progressed to the stage of right ventricular failure. This study provides no evidence that chronic obstructive pulmonary disease results in chronic impairment of left ventricular function, but on the contrary, has demonstrated that the left ventricle responds normally to an increased pressure load in these patients.

Clinical Observations of Acute Friedländer Pneumonia

Excerpt In recent years acute Gram-negative bacterial infections of the lung, among them Friedlander pneumonia, have received renewed attention. The incidence and severity of these infections appea...

The Effect of Pulmonary Emphysema upon Cardiopulmonary Hemodynamics at Rest and During Exercise

Excerpt The aberration in cardiopulmonary hemodynamics occurring in emphysematous subjects at rest is well-known, although there is no clear resolution of the question of the level of the cardiac o...

Percutaneous Needle Biopsy of the Lung in Diffuse Pulmonary Diseases

Excerpt Percutaneous needle biopsy of pulmonary tissue has been used in the past for the bacteriologic study of acute pneumonic processes (1, 2) or for tissue diagnosis of an isolated intrathoracic...

HEMODYNAMIC CONSEQUENCES OF OXYGEN BREATHING IN LEFT VENTRICULAR FAILURE.

As in normal men, oxygen breathing in patients with left ventricular failure is associated with a further reduction of cardiac index, partially the result of decreased stroke index and partially the result of decreased heart rate. The decrease in heart rate and cardiac index is associated with a decrease in left ventricular work index without impairing the delivery of oxygen to the tissues or the over-all tissue pO2. In this group of patients, oxygen breathing did not result in a decreased pulmonary vascular resistance.

Cardiopulmonary hemodynamics during exercise in patients with pulmonary emphysema.

Abstract Five patients with pulmonary emphysema, 4 of whom had pulmonary hypertension at rest, were studied by right heart catheterization with determination of the pulmonary artery and “capillary” pressures and cardiac output at rest and during graded exercise. Two to three minutes of such exercise was sufficient to establish a “steady state” in these parameters, although a somewhat longer period of time may be required in those who have developed right ventricular failure. Pulmonary artery pressure and pulmonary vascular resistance after reaching a stable value do not fall as exericise progresses through nine minutes.

Primary Myocardial Disease: Clinical Features and Hemodynamic Alterations.

Excerpt Thirty-two males, average age 43 years, with idiopathic cardiomegaly and signs and symptoms of heart failure were studied. Fourteen were Negroes (hospital population, 18% Negro). Twenty-one...

The Labile Properties of the Pulmonary Vascular Bed in Patients with Pulmonary Emphysema.

Excerpt The factors which produce pulmonary hypertension in patients with pulmonary emphysema are poorly understood. The present study was undertaken in such patients to determine whether this vasc...