Pulmonary Systolic Blood Pressure Research Articles

The Effectiveness of Bax/Bcl-2 Gene Expression Ratio, Cardiac Function and Pulmonary Hemodynamics Indexes caused by Cardiopulmonary Rehabilitation Nursing.

This study aimed to observe the effects of cardiopulmonary rehabilitation nursing on gene expression, cardiac function and pulmonary hemodynamic indexes after percutaneous coronary intervention (PCI). A total of 104 coronary heart disease patients who received PCI treatment from January 2020 to January 2022 were selected by convenience sampling method. The patients were divided into control and observation groups by random number table method, with 52 cases in each group. The control group received routine nursing and the observation group received cardiopulmonary rehabilitation nursing. Cardiac function and pulmonary hemodynamics indexes were compared between the two groups. To evaluate gene expression, blood was taken from patients and healthy people after receiving complete information and obtaining consent. White blood cells were isolated by salting out. After RNA extraction and cDNA synthesis, the expression levels of Bcl2 and BAX genes were quantitatively measured by real-time PCR. Results showed that one month after discharge, the left ventricular end-diastolic diameter was decreased in the observation group compared with the control group and left ventricular ejection fraction and six minutes walk test grading were increased compared with the control group, showing a significant difference (P< 0.05). The pulmonary hemodynamic indexes were decreased in both groups compared with those at admission, but the pulmonary diastolic blood pressure, pulmonary systolic blood pressure, mean pulmonary artery pressure and pulmonary vascular resistance were lower in the observation group than in the control group of the same period, showing a difference (P< 0.05). The incidence of MACE was 1.92% (1/52) in the observation group, which was lower compared to the control group, showing a difference (P< 0.05). In this study, real-time PCR analysis showed that the expression ratio of Bcl2 to BAX genes in peripheral blood T cells in disease patients compared to healthy people was not different (P=0.07). In conclusion, Cardiopulmonary rehabilitation nursing for coronary heart disease after PCI can promote faster recovery of cardiac function, prolong exercise endurance and improve pulmonary hemodynamics indexes, demonstrating clinical reference value.

A novel method for measuring pulmonary artery pressure by high-frequency ultrasound-guided transthoracic puncture in rats.

ObjectivesThe success of the rat model of pulmonary hypertension (PH) is primarily dependent on the measurement of pulmonary artery pressure. We herein demonstrate a novel method for measuring pulmonary artery pressure through a high-frequency ultrasound-guided transthoracic puncture in rats. The efficacy and time of this novel method are also discussed.MethodsA single subcutaneous injection of monocrotaline (MCT) was used to establish a rat model of PH. Through the heat shaping method, the tip of that puncture cannula was maintained at a certain angle after the needle core was removed. In-plane real-time guided trocar puncture of the right ventricular outflow tract was performed in the short-axis section of the parasternal aorta. The external pressure sensor was used to record the real-time waveform of right ventricular systolic pressure, pulmonary artery systolic pressure, and diastolic pressure.ResultsThe success rates of which using this novel method in the model group and the control group were 88.5 and 86.7%, respectively. The time of puncture pressure measurement was 164 ± 31 and 235 ± 50 s, respectively. The right ventricular systolic blood pressure, pulmonary systolic blood pressure, and diastolic blood pressure of the model group were higher than those of the control group.ConclusionThe modified method for trocar is helpful for accurately positioning pulmonary artery manometry. The method described in this paper has a high success rate and short operation time. It can simultaneously measure systolic blood pressure, diastolic blood pressure, and mean pressure of the right ventricle and pulmonary artery. It has a broad application prospect in verifying the rat PH model and pulmonary artery pressure monitoring.

Feasibility and reproducibility of right ventricle stress echocardiography and its capability to assess the right ventricle contractile reserve of patient with at least trivial tricuspid regurgitation

Abstract Funding Acknowledgements Type of funding sources: None. BACKGROUND. Stress echocardiography (SE) is widely used for the assessment of left ventricular (LV) function, diagnostic and prognostic stratification of patients with coronary artery disease and for assessment of mitral and aortic valve disease. However, the assessment of the right ventricle (RV) in general, and in particular in regard to the contractile reserve of the RV in patients with tricuspid valve (TV) disease is an area that has not been previously explored in adult patients. The physiology and function of the RV is different than that of the LV and the use of SE provides the possibility to test both systolic and diastolic function of the RV in response to increased loading conditions. This can potentially be used to assess the RV function prior to surgery and to predict which subset of patients may benefit from intervention on the TV before the RV displays signs of failure PURPOSE. We therefore propose a study to investigate the potential use of SE for the assessment of RV function in adult patients. The aim is to evaluate the feasibility of RV SE in any patients with more than trivial tricuspid regurgitation (TR) and to assess the presence and degree of RV contractile reserve. METHODS. We enrolled 81 patients undergoing a phisical or dobutamine SE for CV risk stratification or chest pain. Inclusion criteria were age≥ 18 years, normal baseline RV function (FAC&amp;gt; 35%, TAPSE&amp;gt; 16 mm). Exclusion criteria were presence of RV dysfunction, pulmonary stress hypertension, positive stress test for left myocardial ischemia, presence of moderate or severe valvular disease, grade III or higher diastolic dysfunction at baseline, severe respiratory, renal or hepatic dysfunction. We evaluated the average values of TAPSE, fractional area change (FAC), S wave, sPAP (pulmonary systolic blood pressure), RV strain during baseline and at the peak of the effort. We also assessed the reproducibility of these measurement between two different expert operators (blind analysis). RESULTS. We were able to measure the RV parameters both during baseline and at the peak of the effort in all patients, demonstrating an excellent feasibility. Differences in parameters collected at baseline and at peak were assessed using paired Wilcoxon signed rank test. All variables showed a statistical significant increase (p &amp;lt; 0.001) at peak compared to the baseline. Average percentage increases at peak were 31.1% for TAPSE, 24,8% for FAC, 50,6% for S wave, 55,2% for PAPS and 39.8 % for RV strain. Bland-Altman method was used to evaluate the agreement between measurements collected by two separate operators and it showed good Intraclass Correlation Coefficients (Figure). CONCLUSIONS. RV SE proved to be feasible and showed little inter-operator variability in patients with at least trivial TR. It provided valuable informations about RV contractile reserve that may help stratifying the risk of RV failure in patients undergoing TV surgery. Abstract Figure

Can echocardiography predict the diagnosis of obstructive sleep apnea or its severity in a Tunisian population with atrial fibrillation?

It is currently recognised that obstructive sleep apnea (OSA) may affect the function and geometry of heart chambers, which has promoted the development of echocardiographic exploration as one of the tools for screening for the diagnosis of OSA and its severity in the general population. However, few studies have investigated the impact of echocardiographic findings on screening for OSA or its severe forms in patients with atrial fibrillation (AF). Investigate the echocardiographic abnormalities that would be correlated with the positive diagnosis of OSA and the diagnosis of its severity in non-valvular AF patients. This is a cross-sectional study that included 100 patients with non-valvular AF. All patients had an echocardiographic study and overnight polygraphy. OSA's diagnosis was retained in 90% of patients: mild in 32% of cases, moderate in 27% of cases and severe in 31% of cases. In our study, there was no significant difference between groups with and without OSA in terms of left ventricular systolic function, percentage of patients with left ventricular hypertrophy (LVH), left atrium area, systolic function right ventricle and pulmonary systolic blood pressure level. Comparing patients with severe OSA to patients with non-severe OSA, analysis of echocardiographic parameters showed that LVH was significantly more found in patients with severe OSA compared with those with IAH < 30 (58% versus 35.4%, P = 0.036, OR = 2.52, CI 95% : 1.05–6.07). In addition, the surface of the left atrium was positively correlated with hypnea–apnea index ( P = 0.018) and therefore with the severity of OSA. In our study conducted in a Tunisian population with AF, we pointed out that OSA was not significantly associated with the different echocardiographic parameters used, whereas LVH and the left atrial area were significantly more noticeable in the severe OSA group compared to the rest of the population.

Evaluation of Real-Time Three-Dimensional Echocardiography in Right Ventricular Function and Hemodynamics in Patients with Idiopathic Pulmonary Hypertension

Objective: Oriented with the assessment on real-time echocardiography based upon three dimensions (RT-3DE) in estimating right ventricular function and hemodynamics in the patients undergoing idiopathic pulmonary hypertension. Methods: Sixty patients living with idiopathic pulmonary hypertension admitted to our hospital from September 2018 to June 2019 were enrolled. Another 20 healthy examiners were selected as healthy controls. According to pulmonary systolic blood pressure, 60 patients were divided into 20 mild patients, 20 moderate ones as well as 20 severe ones. RT-3DE was used to measure right heart structure related parameters in all subjects, including left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD), right ventricular global end diastolic volume (EDV), right ventricular ejection fraction (RVEF). End-systolic volume (ESV), stroke volume (SV), as well as hemodynamic parameters, including pulmonary systolic pressure (SPAP), right heart output (RCO), pulmonary diastolic blood pressure (DPAP), pulmonary arterial pressure (MPAP). The differences in right heart structure parameters and hemodynamic parameters betwixt the PH Group and the healthy control Group were compared. In addition, conventional two-dimensional echocardiography (2DE) and RT-3DE were used to compare the images of the patients who had serious pulmonary hypertension and those of the Control Group to analyze the tricuspid annulus systolic displacement (TAPSE), the Tei index, and the tricuspid annulus systolic peak velocity (S’) value. The Result is that SPAP, DPAP, and MPAP achieved higher level in the PH Group compared to those in the Healthy Group, and P &lt; 0005, the difference took on statistical significance. Those data of SPAP, DPAP and MPAP in the moderate and severe PH Group were higher than those in the mild PH Group, and P &lt; 0005, the difference was of statistical significance. The RCO of the patients from the PH Group as well as the Healthy Group got under comparison, and P &lt; 0005. They presented statistics-based dramatic difference. In addition, RCO showed a gradual decline in the patients who came down with mild, moderate, and serious PH, and the results were statistically significant. In addition, the comparison between RT-3DE and conventional echocardiography shows that RT-3DE has higher accuracy and diagnostic value.

Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty.

AimsThe aim of this study was to investigate prospectively the effect of sacubitril/valsartan in advanced heart failure (HF) patients in waiting list for heart transplantation (HT) and the effect on physical frailty (PF).Methods and resultsWe treated 37 consecutive patients with advanced HF with sacubitril/valsartan. Patients were followed up until HT, device implant, or last follow‐up visit after 2 years of follow‐up. At baseline, mean New York Heart Association (NYHA) class was 3.1 ± 0.4, with 64.9% in NYHA III and 35.1% NYHA IIIB. Left ventricular ejection fraction was 23.5 ± 5.8%, VO2 max was 10.3 ± 2.3 mL/kg/min, cardiac index was 2.3 ± 0.5 L/min/m2, and N‐terminal pro‐brain natriuretic peptide (NT‐pro‐BNP) was 4943.0 ± 5326.8 pg/mL. After a mean follow‐up of 17.1 ± 4.4 months, no deaths were observed, but NYHA class improved significantly with 56.8% in NYHA II, 40.5% in NYHA III, and 2.7% in NYHA IIIB (P < 0.001). VO2 max and 6 min walk test (6MWT) increased, whereas pulmonary systolic blood pressure, E/E′, VE/VCO2 slope, and NT‐pro‐BNP decreased. At right heart catheterization performed after 1 year of follow‐up, cardiac index and pulmonary vascular resistance remained stable, while a decrease in systolic pulmonary artery pressure and pulmonary capillary wedge pressure is observed. Furosemide dosage decrease from 102.7 ± 69.4 to 78.7 ± 66.3 mg (P = 0.040). PF decreased from 3.35 ± 1.0 at baseline to 1.57 ± 1.3 at the end of follow‐up (P < 0.001), with a reduction in all PF domains.ConclusionsOur study showed a rapid improvement in PF in HT waiting list patients treated with sacubitril/valsartan. The improvement in all PF domains was paralleled by VO2 and 6MWT increase and together with an NT‐pro‐BNP reduction constant over the follow‐up.

P775Effect of sacubitril-valsartan in reducing physical frailty in patients with advanced heart failure in waiting list for heart transplantation

Abstract Background Treatment with valsartan/sacubitril was found to be associated both with reduction in mortality risk for HF. Purpose To investigate the effect of sacubitril/valsartan on physical frailty (PF) in advanced HF patients in waiting list for heart transplantion (HT) in a two years follow-up study. Methods We enrolled 45 consecutive patients (status 2B UNOs). Patients tolerant to ACE-inhibitor and/or ARBs were treated with valsartan/sacubitril. Patients were required to have left ventricular ejection fraction (LVEF) of ≤35% and to be taking a stable dose of a β-blocker and an ACE inhibitor or an ARB for at least 4 weeks before enrollment. The dosage of sacubitril/valsartan was increased if tolerance was good. Frailty was assessed using an adapted version of Fried's Frailty Phenotype used in advanced HF patients in waiting list for transplantation. Patients were followed up until HT, device (TAH/LVAD) implant, or last follow-up visit. Results Mean NYHA class was 3.1±0.4, with 5.7% NYHA 2, 62.9% NYHA 3 and 31.4% NYHA 3B. LVEF was 25.1±6.4, VO2 max (ml/kg/min) was 10.3±2.3, cardiac index (L/min/m2) was 2.3±0.6, and NT-proBNP (pg/ml) was 4054.8±3977. At 3 months, 31.5% of patients received the target dose of 97/103 mg/BID, 31.6% the half dose (49/51mg BID) and 26.3% the low dose (24/26 mg BID) and 10.5% the half low dose (24/26 mg daily). The baseline mean value of physical frailty was 3.86±0.8, specifically 94.3% showed exhaustion, 91.4% physical inactivity, 88.6% weakness, 85.7% slowness and 28.6% loss of appetite. All patients had a frailty score ≥3. During follow-up there were no deaths. After treatment, NYHA class improved significantly (2.4±0.6 vs 3.1±0.4; p=0.002), with 5.7% NYHA 1, 48.6% NYHA 2, 42.9% NYHA 3 and 2.9% NYHA 3B (p&lt;0.001). VO2 max consumption, Six Minute Walking Test increased while pulmonary systolic blood pressure, VE/VCO2 slope, and NT-proBNP, decreased. Both Diastolic and Systolic BP decrease, but only DBP was statistically significant. No differences were observed during follow-up for LVEF, E/E', TAPSE, IVC. A significant reduction in furosemide dosage was observed (103.57±71.3 mg to 81.4±54.6 mg; p=0.040) while no differences were observed in mineral corticoids antagonist and metolazone. These improvements occurred from the first month of treatment and were still significantly present at the end of follow up. PF decreased (3.86±0.8 vs 1.44±1.26; p&lt;0.000) with a significant reduction in all domain of PF. 28.5% had a frailty score ≥3. Conclusions Our study shows an improvement in PH in patients with advanced HF in waiting list for HT after therapy with sacubitril/valsartan. These changes seem to appear very early after introduction of the treatment and to be maintained over time. The improvement in all physical domain was paralleled by VO2 max and 6-minute walking test increase. The pro-BNP-NT reduction was significant in the first month of treatment and remain quite stable in the follow-up.

Clinical Value of Asymmetrical Dimethylarginine Detection in Patients with Connective Tissue Disease-Associated Pulmonary Arterial Hypertension.

Objective To evaluate the clinical value of serum asymmetrical dimethylarginine (ADMA) in patients with connective tissue disease- (CTD-) associated pulmonary arterial hypertension (PAH). Methods 88 patients with CTD were recruited between December 2017 and August 2018 in Jiangxi Provincial People's Hospital. Patients were further divided into two groups: CTD-without PAH (n = 45 cases) and CTD-with PAH (n = 43 cases), according to the pulmonary systolic blood pressure measured by echocardiography. 40 healthy controls were also included (n = 40 cases). The clinical data, including laboratory examinations, echocardiographic measurements, pulmonary function, and serum ADMA levels determined by enzyme-linked immunosorbent assay, (ELISA) were collected. The correlation between ADMA levels and the occurrence of PAH, pulmonary function, and other laboratory indexes in CTD patients were analyzed. Statistical analyses were performed by SPSS (version 23); P < 0.05 was considered statistically significant. Results The serum levels of ADMA in the CTD-PAH group were significantly higher than those of the CTD-without PAH group and healthy control group (P < 0.05); the serum ADMA levels were (0.706 ± 0.153 μmol/L), (1.015 ± 0.122 μmol/L), and (0.661 ± 0.113 μmol/L), respectively. There was no significant difference between the CTD-without PAH group and healthy control group (P < 0.05). Correlation analysis showed that serum ADMA levels were positively correlated with sPAP and NT-proBNP and negatively correlated with DLCO% (r = 0.802, 0.475, −0.585, P < 0.001). Multivariate analysis indicated that elevated serum ADMA levels increased the risk for the appearance of PAH in CTD patients (OR = 57.460, P < 0.001). Using the receiver operating characteristic (ROC) curve analysis, at the cutoff level of 0.810 μmol/L, ADMA showed good diagnostic efficacy as follows: sensitivity was 97.7%, specificity was 75.6%, and the area under the curve (AUC) was 0.947 (P < 0.001). Conclusion Increased ADMA levels are independently associated with the presence and severity of PAH in CTD patients. The levels of ADMA in the serum may contribute to be a noninvasive indicator for early diagnosis of CTD-with PAH patients.

Effect of Phlebotomy Therapy On Hemoglobin Concentration and Tricuspid Regurgitation Velocity in Chuvash Polycythemia.

Abstract 1897Poster Board I-920 Background:Chuvash polycythemia is caused by homozygosity for the VHL598C>T mutation, which leads to up-regulation of HIF-1a and HIF-2a in normoxia. As the result, circulating concentrations of erythropoietin are elevated. Chuvash polycythemia patients suffer from cardiovascular abnormalities that include pulmonary arterial hypertension, thrombosis and stroke. Phlebotomy is a common therapy for patients to decrease symptoms such as plethora and headache. However, the outcomes of phlebotomy have not been assessed for these patients. The objective of this analysis is to evaluate the effect of phlebotomy on hemoglobin concentration, serum concentrations of ferritin and erythropoietin, and echocardiographically-determined tricuspid regurgitation velocity, which reflects systolic pulmonary artery pressure. Methods:One hundred twenty patients homozygous for VHL598C>T and 38 controls of comparable age and gender from Chuvash Republic of the Russian Federation were studied. Clinical and demographic characteristics were determined and echocardiography was performed. Serum ferritin and erythropoietin concentrations were measured by ELISA. Results:The median (interquartile) age for Chuvash polycythemia cases was 36 (22–48) years. They included 68 females (56%). Chuvash polycythemia patients had higher serum erythropoietin concentration (medians of 46 versus 8 mIU/ml, P = 0.0001) and lower serum ferritin concentration (medians of 12 versus 48 ng/ml, P = 0.0001) compared to controls. Tricuspid regurgitation velocity was higher in cases than controls (medians of 2.5 vs. 2.3 m/sec, P = 0.007). Among the cases, 87 (71%) had a history of phlebotomy and 54 of these had phlebotomy within the last year. Phlebotomy was associated with higher erythropoietin concentration (P = 0.033) and lower ferritin concentration (P = 0.024) but no significant difference in hemoglobin concentration (P = 0.9) (Table 1). After adjusting for the effect of age, phlebotomy was associated with significantly higher odds of tricuspid regurgitation velocity ≥2.5 (m/sec) (odds ratio: 3.3; 95% CI: 1.1–9.9).Table 1Iron status and hematologic markers in Chuvash polycythemia patients by history of phlebotomy. Results are in mean (95% confidence interval).No phlebotomy (N = 28)Phlebotomy >1 year ago (N = 25)Phlebotomy in last year (N = 42)P for trendResultsResultsResultsFerritin (ng/ml)*17.6 (11.7–26.3)12.6 (9.9–15.8)8.9 (6.3–12.6)0.024Erythropoietin (mIU/ml)39 (26–54)50 (41–61)64 (49–80)0.033Hemoglobin (g/dL)*18.1 (17.2–19.0)17.9 (17.5–18.5)17.9 (17.1–18.6)0.9*Values are adjusted for age and gender Conclusion:Patients with Chuvash polycythemia tend to mobilize iron stores and increase erythropoietin production to maintain a constant, elevated hemoglobin concentration despite phlebotomy therapy. In this process, estimated pulmonary systolic blood pressure appears to increase. Therefore, phlebotomy therapy might be a risk factor for pulmonary hypertension in the context of Chuvash polycythemia. Disclosures:No relevant conflicts of interest to declare.

Low-dose infusion of atrial natriuretic factor in mild essential hypertension.

Intra-arterial blood pressure, cardiac output, heart rate, right heart indexes, urinary electrolytes, and urinary volume were monitored in eight patients with untreated (WHO Class I) essential hypertension. The patients were given synthetic atrial natriuretic factor (ANF) (99-126 alpha-hANP) at 1 and 2 pmol/kg/min in series (phases 1 and 2, 2 hours each dose) or vehicle (hemaccel) in random order on two separate occasions while on their usual diet. Arterial plasma ANF levels increased significantly from basal and time-matched placebo values from 25 +/- 2 and 28 +/- 3 pmol/l to 50 +/- 4 and 83 +/- 9 pmol/l at the end of phases 1 and 2, respectively (p less than 0.001). After 30 minutes during phase 2, systolic blood pressure decreased significantly by 20 +/- 4 mm Hg (p less than 0.001) from basal and time-matched placebo values and remained significantly reduced (-17 +/- 4 mm Hg, p less than 0.001) by the end of the recovery period (2 hours after infusions were completed). Pulmonary systolic blood pressure decreased by 5 +/- 1 mm Hg (phase 2, p less than 0.05). Cardiac output decreased by 0.5 +/- 0.1 l/min below baseline at the end of phase 2 of ANF infusion, whereas it increased significantly (p less than 0.02) by 0.6 +/- 0.1 l/min during vehicle infusion. Systemic diastolic, pulmonary diastolic, right atrial, and wedge pressures were not significantly changed during ANF or vehicle infusions, nor were pulmonary vascular resistance or heart rate altered. Systemic vascular resistance did not change significantly during both infusions, whereas during recovery, systemic vascular resistance decreased significantly after ANF infusion was discontinued (p less than 0.05). Microhematocrit levels increased dose dependently during ANF. The maximum increase was observed at the end of phase 2 (+4.7 +/- 1.7%), whereas the microhematocrit level decreased to -2.4 +/- 0.6% with vehicle (p less than 0.001) at the end of phase 2. Urinary sodium excretion increased significantly (p less than 0.02) by the end of phase 2 under ANF infusion (+38 +/- 15%), whereas it decreased (-10 +/- 6%) under placebo infusion by the end of phase 2. Urinary magnesium excretion was significantly increased during ANF infusion from phase 1 (p less than 0.02), whereas urinary potassium levels, calcium levels, creatinine levels, volume, and glomerular filtration rate did not differ significantly between the two infusions. Plasma renin, angiotensin II, aldosterone, and catecholamine concentrations did not change significantly during ANF or vehicle infusions.(ABSTRACT TRUNCATED AT 400 WORDS)

Studies on the carotid body and the carotid sinus. Circulatory effects of the carotid chemoreflex.

Previously, carotid chemoreflex and baroreflex have been reported, although for the most part of these mechanisms have not been clarified.In this experiments, circulatory effects of the carotid chemoreflex were investigated in the anesthetized dogs. Chemoreflex was performed with Lobeline (0.02mg, 1ml) and potassium cyanide (KCN, 1%, 1ml) through the catheter inserted to the carotid sinus. Continuously, during experiments, systolic blood pressure (S. P), diastolic blood pressure (D. P), systolic pulmonary blood pressure (SPaP), diastolic pulmonary blood pressure (DPaP), respiration and pulse rate were recorded simultaneously in the closed chest dogs. Cardiac output, pulmonary blood flow, coronary blood flow, S. P, D. P, SPaP, DPaP, and pulse rate were examined in the controlled breathing of the open chest dogs.In each experiment, during and after reflex, blood gas, HCO3-, and pH were measured. However, none of them were changed by these reflexes.In the case of the closed chest dogs, chemoreflex by Lobeline did not change S. P and D. P, but SPaP was increased by 22.54%, significantly. DPaP was increased by 18.14%. Respiration rate was increased by 26.46% significantly. Heart rate was decreased by 9.15%.In the open chest dogs, chemoreflex by Lobeline increased S. P and D. P by 13.05% and 14.58% significantly. SPaP and DPaP were increased by 22.19% and 21.97% significantly. Pulmonary resistance was increased by 28.57% significantly. Pulmonary blood flow was decreased by 9.7% significantly.In the open chest dogs, chemoreflex with KCN increased S. P, D. P, and SPaP by 21.59%, 21.39%, and 41.02% significantly. Pulmonary resistance was increased by 20% significantly. Pulmonary blood flow was decreased by 10.43%. Cardiac output was not changed but coronary blood flow was increased by 6.50% significantly.It should be noted here that the carotid chemoreflex caused the hyperrespiration, the changes of pulmonary arterial blood pressure, pulmonary resistance, and pulmonary blood flow significantly, but these hemodynamic changes are capable of being separated from the effects of hyperrespiration through the chemoreflex mechanism.