Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study

ABSTRACT BACKGROUND: The mechanism of exercise limitation in idiopathic pulmonary arterial hypertension (IPAH) is not fully understood. The role of hemodynamic alterations is well recognized, but mechanical, ventilatory and gasometric factors may also contribute to reduction of exercise capacity in these individuals. OBJECTIVE: To investigate whether there is an association between ventilatory pattern and stress Doppler echocardiography (SDE) variables in IPAH patients. DESIGN AND SETTING: Single-center prospective study conducted in a Brazilian university hospital. METHODS: We included 14 stable IPAH patients and 14 age and sex-matched controls. Volumetric capnography (VCap), spirometry, six-minute walk test and SDE were performed on both the patients and the control subjects. Arterial blood gases were collected only from the patients. The IPAH patients and control subjects were compared with regard to the abovementioned variables. RESULTS: The mean age of the patients was 38.4 years, and 78.6% were women. The patients showed hypocapnia, and in spirometry 42.9% presented forced vital capacity (FVC) below the lower limit of normality. In VCap, IPAH patients had higher respiratory rates (RR) and lower elimination of CO2 in each breath. There was a significant correlation between reduced FVC and the magnitude of increases in tricuspid regurgitation velocity (TRV). In IPAH patients, VCap showed similar tidal volumes and a higher RR, which at least partially explained the hypocapnia. CONCLUSIONS: The patients with IPAH showed hypocapnia, probably related to their higher respiratory rate with preserved tidal volumes; FVC was reduced and this reduction was positively correlated with cardiac output.

Brasil 1985:Relatório sobre a situaçäo Social do País / Brasil 1985: Relatório sobre a situaçäo social do País / Brazil 1985:Report about Social Situation of country

Brasil 1985 -Relatório sobre a Situaçäo Social do País é o primeiro volume de um trabalho anual que está sendo realizado por professores, pesquisadores e estudantes vinculados ao Instituto de Filosofia e Ciencias Humanas, ao Instituto de Economia, ao Departamento de Ciências Sociais Aplicadas à Educaçäo da Faculadade de Educaçäo, esforço coordenado pelo NEPP (Núcleo de Estudos em Políticas Públicas e plos Centro de Estudos de Desenvolvimento Econömico e Centro de Estudos de Conjuntura do Instituto de Economia da UNICAMP. A dimensäo Nacional é o ponto de partida deste Relatório, näo só porque define o quadro geral que preside os movimentos regionais, estaduais e municipais, como permite uma incorporaçäo posterior dos outros níveis de análise, de caráter mais local

Brasil 1985: Relátorio sobre a situaçäo social do País / Brasil 1985: Relatório sobre a situaçäo social do País / Brazil 1985: Report about Social Situation of Country

O segundo volume de Brasil 1985 -Relatório sobre a Situaçäo Social do País trata da reconstituiçäo do perfíl e da evoluçäo recente das políticas federais relativas à Educaçäo,Habitaçäo, Alimentaçäo e Nutriçäo programas assistenciais de responsabilidade da LBA e da FUNABEM