Pulmonary vascular resistance and compliance relationship in pulmonary hypertension.
Identifieur interne : 002941 ( Main/Exploration ); précédent : 002940; suivant : 002942Pulmonary vascular resistance and compliance relationship in pulmonary hypertension.
Auteurs : Denis Chemla [France] ; Edmund M T. Lau [Australie] ; Yves Papelier [France] ; Pierre Attal [Israël] ; Philippe Hervé [France]Source :
- The European respiratory journal [ 1399-3003 ] ; 2015.
Descripteurs français
- KwdFr :
- Artère pulmonaire (anatomopathologie), Artère pulmonaire (physiopathologie), Circulation pulmonaire, Dysfonction ventriculaire droite (physiopathologie), Débit systolique, Humains, Hypertension pulmonaire (physiopathologie), Pneumologie (), Poumon (physiopathologie), Pression artérielle pulmonaire d'occlusion, Pression sanguine, Pronostic, Reproductibilité des résultats, Résistance vasculaire, Systole, Valeurs de référence, Ventricules cardiaques (physiopathologie), Élasticité.
- MESH :
- anatomopathologie : Artère pulmonaire.
- physiopathologie : Artère pulmonaire, Dysfonction ventriculaire droite, Hypertension pulmonaire, Poumon, Ventricules cardiaques.
- Circulation pulmonaire, Débit systolique, Humains, Pneumologie, Pression artérielle pulmonaire d'occlusion, Pression sanguine, Pronostic, Reproductibilité des résultats, Résistance vasculaire, Systole, Valeurs de référence, Élasticité.
English descriptors
- KwdEn :
- Blood Pressure, Elasticity, Heart Ventricles (physiopathology), Humans, Hypertension, Pulmonary (physiopathology), Lung (physiopathology), Prognosis, Pulmonary Artery (pathology), Pulmonary Artery (physiopathology), Pulmonary Circulation, Pulmonary Medicine (methods), Pulmonary Wedge Pressure, Reference Values, Reproducibility of Results, Stroke Volume, Systole, Vascular Resistance, Ventricular Dysfunction, Right (physiopathology).
- MESH :
- methods : Pulmonary Medicine.
- pathology : Pulmonary Artery.
- physiopathology : Heart Ventricles, Hypertension, Pulmonary, Lung, Pulmonary Artery, Ventricular Dysfunction, Right.
- Blood Pressure, Elasticity, Humans, Prognosis, Pulmonary Circulation, Pulmonary Wedge Pressure, Reference Values, Reproducibility of Results, Stroke Volume, Systole, Vascular Resistance.
Abstract
Right ventricular adaptation to the increased pulmonary arterial load is a key determinant of outcomes in pulmonary hypertension (PH). Pulmonary vascular resistance (PVR) and total arterial compliance (C) quantify resistive and elastic properties of pulmonary arteries that modulate the steady and pulsatile components of pulmonary arterial load, respectively. PVR is commonly calculated as transpulmonary pressure gradient over pulmonary flow and total arterial compliance as stroke volume over pulmonary arterial pulse pressure (SV/PApp). Assuming that there is an inverse, hyperbolic relationship between PVR and C, recent studies have popularised the concept that their product (RC-time of the pulmonary circulation, in seconds) is "constant" in health and diseases. However, emerging evidence suggests that this concept should be challenged, with shortened RC-times documented in post-capillary PH and normotensive subjects. Furthermore, reported RC-times in the literature have consistently demonstrated significant scatter around the mean. In precapillary PH, the true PVR can be overestimated if one uses the standard PVR equation because the zero-flow pressure may be significantly higher than pulmonary arterial wedge pressure. Furthermore, SV/PApp may also overestimate true C. Further studies are needed to clarify some of the inconsistencies of pulmonary RC-time, as this has major implications for our understanding of the arterial load in diseases of the pulmonary circulation.
DOI: 10.1183/13993003.00741-2015
PubMed: 26341990
Affiliations:
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Paris-Sud, Faculté de Médecine, Inserm U_999, Le Kremlin Bicêtre, France AP-HP, Services des Explorations Fonctionnelles, Hôpital de Bicêtre, Le Kremlin Bicêtre, France denis.chemla@bct.aphp.fr.</nlm:affiliation><country wicri:rule="url">France</country><wicri:regionArea>Univ. Paris-Sud, Faculté de Médecine, Inserm U_999, Le Kremlin Bicêtre, France AP-HP, Services des Explorations Fonctionnelles, Hôpital de Bicêtre, Le Kremlin Bicêtre</wicri:regionArea><wicri:noRegion>Le Kremlin Bicêtre</wicri:noRegion><wicri:noRegion>Le Kremlin Bicêtre</wicri:noRegion></affiliation></author><author><name sortKey="Lau, Edmund M T" sort="Lau, Edmund M T" uniqKey="Lau E" first="Edmund M T" last="Lau">Edmund M T. Lau</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Faculté de Médecine, Inserm U_999, Le Kremlin Bicêtre, France AP-HP, Services des Explorations Fonctionnelles, Hôpital de Bicêtre, Le Kremlin Bicêtre, France Dept of Respiratory Medicine, Royal Prince Alfred Hospital, University of Sydney, Camperdown, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Univ. Paris-Sud, Faculté de Médecine, Inserm U_999, Le Kremlin Bicêtre, France AP-HP, Services des Explorations Fonctionnelles, Hôpital de Bicêtre, Le Kremlin Bicêtre, France Dept of Respiratory Medicine, Royal Prince Alfred Hospital, University of Sydney, Camperdown</wicri:regionArea><wicri:noRegion>Camperdown</wicri:noRegion></affiliation></author><author><name sortKey="Papelier, Yves" sort="Papelier, Yves" uniqKey="Papelier Y" first="Yves" last="Papelier">Yves Papelier</name><affiliation wicri:level="1"><nlm:affiliation>AP-HP, Services des Explorations Fonctionnelles, Hôpital de Bicêtre, Le Kremlin Bicêtre, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, Services des Explorations Fonctionnelles, Hôpital de Bicêtre, Le Kremlin Bicêtre</wicri:regionArea><wicri:noRegion>Le Kremlin Bicêtre</wicri:noRegion><wicri:noRegion>Le Kremlin Bicêtre</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Pierre" sort="Attal, Pierre" uniqKey="Attal P" first="Pierre" last="Attal">Pierre Attal</name><affiliation wicri:level="1"><nlm:affiliation>Dept of Otolaryngology-Head and Neck Surgery, Shaare-Zedek Medical Center and Hebrew University Medical School, Jerusalem, Israel.</nlm:affiliation><country xml:lang="fr">Israël</country><wicri:regionArea>Dept of Otolaryngology-Head and Neck Surgery, Shaare-Zedek Medical Center and Hebrew University Medical School, Jerusalem</wicri:regionArea><wicri:noRegion>Jerusalem</wicri:noRegion></affiliation></author><author><name sortKey="Herve, Philippe" sort="Herve, Philippe" uniqKey="Herve P" first="Philippe" last="Hervé">Philippe Hervé</name><affiliation wicri:level="1"><nlm:affiliation>Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson</wicri:regionArea><wicri:noRegion>Le Plessis-Robinson</wicri:noRegion><wicri:noRegion>Le Plessis-Robinson</wicri:noRegion></affiliation></author></analytic><series><title level="j">The European respiratory journal</title><idno type="eISSN">1399-3003</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Blood Pressure</term><term>Elasticity</term><term>Heart Ventricles (physiopathology)</term><term>Humans</term><term>Hypertension, Pulmonary (physiopathology)</term><term>Lung (physiopathology)</term><term>Prognosis</term><term>Pulmonary Artery (pathology)</term><term>Pulmonary Artery (physiopathology)</term><term>Pulmonary Circulation</term><term>Pulmonary Medicine (methods)</term><term>Pulmonary Wedge Pressure</term><term>Reference Values</term><term>Reproducibility of Results</term><term>Stroke Volume</term><term>Systole</term><term>Vascular Resistance</term><term>Ventricular Dysfunction, Right (physiopathology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Artère pulmonaire (anatomopathologie)</term><term>Artère pulmonaire (physiopathologie)</term><term>Circulation pulmonaire</term><term>Dysfonction ventriculaire droite (physiopathologie)</term><term>Débit systolique</term><term>Humains</term><term>Hypertension pulmonaire (physiopathologie)</term><term>Pneumologie ()</term><term>Poumon (physiopathologie)</term><term>Pression artérielle pulmonaire d'occlusion</term><term>Pression sanguine</term><term>Pronostic</term><term>Reproductibilité des résultats</term><term>Résistance vasculaire</term><term>Systole</term><term>Valeurs de référence</term><term>Ventricules cardiaques (physiopathologie)</term><term>Élasticité</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Artère pulmonaire</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Pulmonary Medicine</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Pulmonary Artery</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Artère pulmonaire</term><term>Dysfonction ventriculaire droite</term><term>Hypertension pulmonaire</term><term>Poumon</term><term>Ventricules cardiaques</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Heart Ventricles</term><term>Hypertension, Pulmonary</term><term>Lung</term><term>Pulmonary Artery</term><term>Ventricular Dysfunction, Right</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Blood Pressure</term><term>Elasticity</term><term>Humans</term><term>Prognosis</term><term>Pulmonary Circulation</term><term>Pulmonary Wedge Pressure</term><term>Reference Values</term><term>Reproducibility of Results</term><term>Stroke Volume</term><term>Systole</term><term>Vascular Resistance</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Circulation pulmonaire</term><term>Débit systolique</term><term>Humains</term><term>Pneumologie</term><term>Pression artérielle pulmonaire d'occlusion</term><term>Pression sanguine</term><term>Pronostic</term><term>Reproductibilité des résultats</term><term>Résistance vasculaire</term><term>Systole</term><term>Valeurs de référence</term><term>Élasticité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Right ventricular adaptation to the increased pulmonary arterial load is a key determinant of outcomes in pulmonary hypertension (PH). Pulmonary vascular resistance (PVR) and total arterial compliance (C) quantify resistive and elastic properties of pulmonary arteries that modulate the steady and pulsatile components of pulmonary arterial load, respectively. PVR is commonly calculated as transpulmonary pressure gradient over pulmonary flow and total arterial compliance as stroke volume over pulmonary arterial pulse pressure (SV/PApp). Assuming that there is an inverse, hyperbolic relationship between PVR and C, recent studies have popularised the concept that their product (RC-time of the pulmonary circulation, in seconds) is "constant" in health and diseases. However, emerging evidence suggests that this concept should be challenged, with shortened RC-times documented in post-capillary PH and normotensive subjects. Furthermore, reported RC-times in the literature have consistently demonstrated significant scatter around the mean. In precapillary PH, the true PVR can be overestimated if one uses the standard PVR equation because the zero-flow pressure may be significantly higher than pulmonary arterial wedge pressure. Furthermore, SV/PApp may also overestimate true C. Further studies are needed to clarify some of the inconsistencies of pulmonary RC-time, as this has major implications for our understanding of the arterial load in diseases of the pulmonary circulation.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Israël</li></country></list><tree><country name="France"><noRegion><name sortKey="Chemla, Denis" sort="Chemla, Denis" uniqKey="Chemla D" first="Denis" last="Chemla">Denis Chemla</name></noRegion><name sortKey="Herve, Philippe" sort="Herve, Philippe" uniqKey="Herve P" first="Philippe" last="Hervé">Philippe Hervé</name><name sortKey="Papelier, Yves" sort="Papelier, Yves" uniqKey="Papelier Y" first="Yves" last="Papelier">Yves Papelier</name></country><country name="Australie"><noRegion><name sortKey="Lau, Edmund M T" sort="Lau, Edmund M T" uniqKey="Lau E" first="Edmund M T" last="Lau">Edmund M T. Lau</name></noRegion></country><country name="Israël"><noRegion><name sortKey="Attal, Pierre" sort="Attal, Pierre" uniqKey="Attal P" first="Pierre" last="Attal">Pierre Attal</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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