Influence of Thoracic Fluid Compartments on Pulmonary Congestion in Chronic Heart Failure

Steven C. Chase, Bryan J. Taylor, Troy J. Cross, Kirsten E. Coffman, Lyle J. Olson, Bruce D. Johnson

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Introduction Pulmonary congestion is a common finding of heart failure (HF), but it remains unclear how pulmonary and heart blood volumes (Vp and Vh, respectively) and extravascular lung water (EVLW) change in stable HF and affect lung function. Methods Fourteen patients with HF (age 68 ± 11 y, LVEF 33 ± 8%) and 12 control subjects (age 65 ± 9 y) were recruited. A pulmonary function test, thoracic computerized tomographic (CT) scan, and contrast perfusion scan were performed. From the thoracic scan, a histogram of CT attenuation of lung tissue was generated and skew, kurtosis, and full-width half-max (FWHM) calculated as surrogates of EVLW. Blood volumes were calculated from the transit time of the contrast through the great vessels of the heart. Results Patients with HF had greater Vp and Vh (Vp 0.55 ± 0.21 L vs 0.41 ± 0.13 L; Vh 0.53 ± 0.33 L vs 0.40 ± 0.15 L) and EVLW (skew 3.2 ± 0.5 vs 3.7 ± 0.7; kurtosis 19.4 ± 6.6 vs 25.9 ± 9.4; FWHM 73 ± 13 HU vs 59 ± 9 HU). Spirometric measures were decreased in HF (percentage of predicted: forced vital capacity 86 ± 17% vs 104 ± 9%; forced expiratory volume in 1 second 83 ± 20% vs 105 ± 11%; maximal mid-expiratory flow 82 ± 42% vs 115 ± 43%). Vp was associated with decreased expiratory flows, and EVLW was associated with decreased lung volumes. Conclusions Congestion in stable patients with HF includes expanded Vp and Vh and increased EVLW associated with reductions in lung volumes and expiratory flows.

Original languageEnglish (US)
Pages (from-to)690-696
Number of pages7
JournalJournal of Cardiac Failure
Volume23
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • Pulmonary function
  • computed tomography
  • thoracic fluid volumes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Influence of Thoracic Fluid Compartments on Pulmonary Congestion in Chronic Heart Failure'. Together they form a unique fingerprint.

  • Cite this