Effect of β2-adrenergic receptor stimulation on lung fluid in stable heart failure patients

Bryan J. Taylor, Eric M. Snyder, Maile L. Richert, Courtney M. Wheatley, Steven C. Chase, Lyle J. Olson, Bruce David Johnson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The purpose of this study was to determine: (1) whether stable heart failure patients with reduced ejection fraction (HFrEF) have elevated extravascular lung water (EVLW) when compared with healthy control subjects; and (2) the effect of acute β2-adrenergic receptor (β2AR) agonist inhalation on lung fluid balance. Methods: Twenty-two stable HFrEF patients and 18 age- and gender-matched healthy subjects were studied. Lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary membrane conductance (DmCO), pulmonary capillary blood volume (Vc) (via re-breathe) and lung tissue volume (Vtis) (via computed tomography) were assessed before and within 30 minutes after administration of nebulized albuterol. EVLW was derived as Vtis - Vc. Results: Before administration of albuterol, Vtis and EVLW were higher in HFrEF vs control (998 ± 200 vs 884 ± 123 ml, p = 0.041; and 943 ± 202 vs 802 ± 133 ml, p = 0.015, respectively). Albuterol decreased Vtis and EVLW in HFrEF patients (-4.6 ± 7.8%, p = 0.010; -4.6 ± 8.8%, p = 0.018) and control subjects (-2.8 ± 4.9%, p = 0.029; -3.0 ± 5.7%, p = 0.045). There was an inverse relationship between pre-albuterol values and pre- to post-albuterol change for EVLW (r 2 = -0.264, p = 0.015) and DmCO (r 2 = -0.343, p = 0.004) in HFrEF only. Conclusion: Lung fluid is elevated in stable HFrEF patients relative to healthy subjects. Stimulation of β2ARs may cause fluid removal in HFrEF, especially in patients with greater evidence of increased lung water at baseline.

Original languageEnglish (US)
JournalJournal of Heart and Lung Transplantation
DOIs
StateAccepted/In press - 2016

Fingerprint

Adrenergic Receptors
Heart Failure
Extravascular Lung Water
Lung
Albuterol
Healthy Volunteers
Lung Volume Measurements
Adrenergic Agonists
Water-Electrolyte Balance
Membranes
Carbon Monoxide
Blood Volume
Inhalation
Tomography
Water

Keywords

  • Albuterol
  • Alveolar-capillary membrane conductance
  • Computed tomography
  • Lung diffusing capacity
  • Pulmonary edema

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Effect of β2-adrenergic receptor stimulation on lung fluid in stable heart failure patients. / Taylor, Bryan J.; Snyder, Eric M.; Richert, Maile L.; Wheatley, Courtney M.; Chase, Steven C.; Olson, Lyle J.; Johnson, Bruce David.

In: Journal of Heart and Lung Transplantation, 2016.

Research output: Contribution to journalArticle

Taylor, Bryan J. ; Snyder, Eric M. ; Richert, Maile L. ; Wheatley, Courtney M. ; Chase, Steven C. ; Olson, Lyle J. ; Johnson, Bruce David. / Effect of β2-adrenergic receptor stimulation on lung fluid in stable heart failure patients. In: Journal of Heart and Lung Transplantation. 2016.
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abstract = "Background: The purpose of this study was to determine: (1) whether stable heart failure patients with reduced ejection fraction (HFrEF) have elevated extravascular lung water (EVLW) when compared with healthy control subjects; and (2) the effect of acute β2-adrenergic receptor (β2AR) agonist inhalation on lung fluid balance. Methods: Twenty-two stable HFrEF patients and 18 age- and gender-matched healthy subjects were studied. Lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary membrane conductance (DmCO), pulmonary capillary blood volume (Vc) (via re-breathe) and lung tissue volume (Vtis) (via computed tomography) were assessed before and within 30 minutes after administration of nebulized albuterol. EVLW was derived as Vtis - Vc. Results: Before administration of albuterol, Vtis and EVLW were higher in HFrEF vs control (998 ± 200 vs 884 ± 123 ml, p = 0.041; and 943 ± 202 vs 802 ± 133 ml, p = 0.015, respectively). Albuterol decreased Vtis and EVLW in HFrEF patients (-4.6 ± 7.8{\%}, p = 0.010; -4.6 ± 8.8{\%}, p = 0.018) and control subjects (-2.8 ± 4.9{\%}, p = 0.029; -3.0 ± 5.7{\%}, p = 0.045). There was an inverse relationship between pre-albuterol values and pre- to post-albuterol change for EVLW (r 2 = -0.264, p = 0.015) and DmCO (r 2 = -0.343, p = 0.004) in HFrEF only. Conclusion: Lung fluid is elevated in stable HFrEF patients relative to healthy subjects. Stimulation of β2ARs may cause fluid removal in HFrEF, especially in patients with greater evidence of increased lung water at baseline.",
keywords = "Albuterol, Alveolar-capillary membrane conductance, Computed tomography, Lung diffusing capacity, Pulmonary edema",
author = "Taylor, {Bryan J.} and Snyder, {Eric M.} and Richert, {Maile L.} and Wheatley, {Courtney M.} and Chase, {Steven C.} and Olson, {Lyle J.} and Johnson, {Bruce David}",
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TY - JOUR

T1 - Effect of β2-adrenergic receptor stimulation on lung fluid in stable heart failure patients

AU - Taylor, Bryan J.

AU - Snyder, Eric M.

AU - Richert, Maile L.

AU - Wheatley, Courtney M.

AU - Chase, Steven C.

AU - Olson, Lyle J.

AU - Johnson, Bruce David

PY - 2016

Y1 - 2016

N2 - Background: The purpose of this study was to determine: (1) whether stable heart failure patients with reduced ejection fraction (HFrEF) have elevated extravascular lung water (EVLW) when compared with healthy control subjects; and (2) the effect of acute β2-adrenergic receptor (β2AR) agonist inhalation on lung fluid balance. Methods: Twenty-two stable HFrEF patients and 18 age- and gender-matched healthy subjects were studied. Lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary membrane conductance (DmCO), pulmonary capillary blood volume (Vc) (via re-breathe) and lung tissue volume (Vtis) (via computed tomography) were assessed before and within 30 minutes after administration of nebulized albuterol. EVLW was derived as Vtis - Vc. Results: Before administration of albuterol, Vtis and EVLW were higher in HFrEF vs control (998 ± 200 vs 884 ± 123 ml, p = 0.041; and 943 ± 202 vs 802 ± 133 ml, p = 0.015, respectively). Albuterol decreased Vtis and EVLW in HFrEF patients (-4.6 ± 7.8%, p = 0.010; -4.6 ± 8.8%, p = 0.018) and control subjects (-2.8 ± 4.9%, p = 0.029; -3.0 ± 5.7%, p = 0.045). There was an inverse relationship between pre-albuterol values and pre- to post-albuterol change for EVLW (r 2 = -0.264, p = 0.015) and DmCO (r 2 = -0.343, p = 0.004) in HFrEF only. Conclusion: Lung fluid is elevated in stable HFrEF patients relative to healthy subjects. Stimulation of β2ARs may cause fluid removal in HFrEF, especially in patients with greater evidence of increased lung water at baseline.

AB - Background: The purpose of this study was to determine: (1) whether stable heart failure patients with reduced ejection fraction (HFrEF) have elevated extravascular lung water (EVLW) when compared with healthy control subjects; and (2) the effect of acute β2-adrenergic receptor (β2AR) agonist inhalation on lung fluid balance. Methods: Twenty-two stable HFrEF patients and 18 age- and gender-matched healthy subjects were studied. Lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary membrane conductance (DmCO), pulmonary capillary blood volume (Vc) (via re-breathe) and lung tissue volume (Vtis) (via computed tomography) were assessed before and within 30 minutes after administration of nebulized albuterol. EVLW was derived as Vtis - Vc. Results: Before administration of albuterol, Vtis and EVLW were higher in HFrEF vs control (998 ± 200 vs 884 ± 123 ml, p = 0.041; and 943 ± 202 vs 802 ± 133 ml, p = 0.015, respectively). Albuterol decreased Vtis and EVLW in HFrEF patients (-4.6 ± 7.8%, p = 0.010; -4.6 ± 8.8%, p = 0.018) and control subjects (-2.8 ± 4.9%, p = 0.029; -3.0 ± 5.7%, p = 0.045). There was an inverse relationship between pre-albuterol values and pre- to post-albuterol change for EVLW (r 2 = -0.264, p = 0.015) and DmCO (r 2 = -0.343, p = 0.004) in HFrEF only. Conclusion: Lung fluid is elevated in stable HFrEF patients relative to healthy subjects. Stimulation of β2ARs may cause fluid removal in HFrEF, especially in patients with greater evidence of increased lung water at baseline.

KW - Albuterol

KW - Alveolar-capillary membrane conductance

KW - Computed tomography

KW - Lung diffusing capacity

KW - Pulmonary edema

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