Right ventricular function and pulmonary hemodynamics during exercise in patients with chronic obstructive bronchopulmonary disease.

Abstract

Central hemodynamics were examined in 50 patients with chronic obstructive bronchopulmonary disease at rest and during mild steady-state supine exercise. The cardiac output rose proportionally to increased oxygen uptake in most cases; there was no difference between the patients with and without chronic right heart failure (RHF). The mean pulmonary arterial pressure in exercise increased disproportionally to cardiac output in about half of the compensated patients and in all cases with RHF. The pulmonary vascular resistance did not change significantly. The right ventricular end-diastolic pressure (RVEDP) at rest was significantly higher in the patients with RHF than in the other but the individual variations were large. Thus, the resting RVEDP cannot be considered as a reliable sign of RV functional abnormality in individual cases. Better agreement with clinical classification of the patients was obtained when considering the exercise values of RVEDP and particularly the relation of RVEDP to stroke volume during exercise.