Abstract
Background β2-adrenergic receptor (β2AR) stimulation promotes lung fluid removal in animals and healthy humans. It is possible that lung fluid accumulation in heart failure (HF) patients is caused by impairment in lung fluid regulation via desensitization of the lung β2ARs. Purpose To determine the effect of an acute inhaled β2AR agonist on lung fluid in HF. Methods/Results 22 stable HF patients and 22 healthy age and gender matched subjects were studied. Lung fluid was estimated at baseline (BL) and up to 30 min after administration of nebulized albuterol by measuring lung diffusing capacity for CO (DLCO), alveolar-capillary conductance (Dm) and pulmonary capillary blood volume (Vc) using a rebreathe method. Pre-inhalation, DLCO was not different in HF vs. healthy subjects (16±5 vs. 19±4 ml/min/mmHg, P=0.06). By contrast, Dm/Vc was greater in HF vs. healthy subjects (0.42 ± 0.14 vs. 0.33 ± 0.15, P=0.04). In HF, group mean DLCO, Dm and Dm/Vc were not different pre- vs. post-albuterol. However, patients who had an increase in DLCO and Dm/Vc with albuterol administration had significantly lower BL values compared to patients who had no improvement (P<0.05). That is, β2AR stimulation improved DLCO and Dm/Vc only in subjects who had evidence for increased lung fluid at BL. Conclusion Stimulation of β2AR may stimulate fluid removal in stable HF patients who exhibit evidence for elevated lung water at rest. HL71478.
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