Original Articles
Lung Function in Cardiac Dysfunction
S. Ricarta, P. Casana,
, J. Bellido-Casadoa, M. Gonzáleza, C. Cotesb, L. Lópezb, J. Beldaa, A. Bayés-Ginésb
Corresponding author
pcasan@hsp.santpau.es
Correspondence: Dr. P. Casan. Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Sant Antoni Maria Claret, 167. 08025 Barcelona. España
Correspondence: Dr. P. Casan. Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Sant Antoni Maria Claret, 167. 08025 Barcelona. España
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Bayés-Ginés" "autores" => array:8 [ 0 => array:3 [ "nombre" => "S." "apellidos" => "Ricart" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:5 [ "preGrado" => "Dr." "nombre" => "P." "apellidos" => "Casan" "email" => array:1 [ 0 => "pcasan@hsp.santpau.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Bellido-Casado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "C." "apellidos" => "Cotes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 5 => array:3 [ "nombre" => "L." "apellidos" => "López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 6 => array:3 [ "nombre" => "J." "apellidos" => "Belda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 7 => array:3 [ "nombre" => "A." "apellidos" => "Bayés-Ginés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Neumología, Hospital de la Santa Creu i de Sant Pau, Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departamento de Cardiología, Hospital de la Santa Creu i de Sant Pau, Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. P. Casan. Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Sant Antoni Maria Claret, 167. 08025 Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-06-17" "fechaAceptado" => "2003-08-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153265" "palabras" => array:4 [ 0 => "Heart failure" 1 => "Spirometry" 2 => "Arterial blood gasometry" 3 => "Echocardiography" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153264" "palabras" => array:4 [ 0 => "Insuficiencia cardíaca" 1 => "Espirometría" 2 => "Gasometría arterial" 3 => "Ecocardiografía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The alterations in lung function caused by heart failure were first described some decades ago. The advent of new tools for the diagnosis and investigation of heart disease, such as echocardiography, has subsequently made it possible to classify cardiac dysfunction with greater precision. The objective of this study was to analyze and compare a series of lung function and gas exchange variables in patients who had been classified into 4 groups according to type of heart disease as diagnosed by echocardiography.</p> <span class="elsevierStyleSectionTitle">Materials and Method</span><p class="elsevierStyleSimplePara elsevierViewall">Emergency room patients whose main symptom was acute dyspnea caused by cardiac or respiratory disease were included in the study. The final sample comprised 71 patients whose echocardiogram revealed cardiac dysfunction. Spirometry was carried out and resting arterial blood gases measured in this group.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 71 patients with cardiopathy, 31 had systolic dysfunction, 27 diastolic dysfunction, 7 cor pulmonale, and 6 primary valve disease. Spirometry revealed a generally obstructive pattern, more marked in the group with cor pulmonale. Analysis of arterial blood gases revealed slight hypoxemia with normocapnia in all groups, but this was more accentuated in the patients with cor pulmonale and diastolic dysfunction. An analysis of the correlations (Pearson's r) between cardiac and pulmonary variables revealed the statistically significant associations between cardiac mass and other variables to be as follows: forced vital capacity r=0.34 (<span class="elsevierStyleItalic">P</span>=.02), forced expiratory volume in one second r=0.526 (<span class="elsevierStyleItalic">P</span>=.0001), forced expiratory volume in one second as a percentage of predicted r=0.3 (<span class="elsevierStyleItalic">P</span>=.037), and forced midexpiratory flow rate r=0.31 (<span class="elsevierStyleItalic">P</span>=.03). The correlation between left ventricular ejection fraction and PaO<span class="elsevierStyleInf">2</span> was r=-0.312 (<span class="elsevierStyleItalic">P</span>=.01); the correlation between left ventricular end-diastolic diameter and PaO<span class="elsevierStyleInf">2</span> was r=0.369 (p=.006).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">In patients with cardiac dysfunction, spirometry reveals a generally obstructive pattern, which is more accentuated in patients with right ventricular dysfunction owing to the existence of prior lung disease. The associations found between the cardiac and lung function variables do not help the physician to determine the predominant diagnosis for a patient more precisely or to establish a prognosis.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Las modificaciones de la función pulmonar producidas por la insuficiencia cardíaca se describieron hace ya varias décadas. La incorporación de nuevos ins-trumentos de diagnóstico y valoración, como la ecocardio-grafía, ha permitido una mejor clasificación de la disfunción cardíaca. El objetivo de este estudio fue analizar y comparar diversas variables de función pulmonar y del intercambio de gases en 4 grupos de pacientes, clasificados en función de la patología cardíaca diagnosticada por eco-cardiografía.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el estudio a pacientes que acudieron a urgencias por disnea aguda, de origen car-díaco o respiratorio, como principal síntoma. La muestra final estuvo compuesta por 71 individuos con disfunción cardíaca evidenciada mediante ecocardiografía, a los que se realizaron una espirometría y la determinación de gases ar-teriales en reposo. Los datos se expresan como media y des-viación estándar.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De los 71 pacientes con cardiopatía, 31 mos-traron disfunción sistólica, 27 diastólica, 7 <span class="elsevierStyleItalic">cor pulmonale</span> y 6 patología valvular primaria. La espirometría mostró un patrón globalmente obstructivo, más marcado en el grupo con <span class="elsevierStyleItalic">cor pulmonale.</span> El análisis de los gases en sangre eviden-ció una ligera hipoxemia con normocapnia en todos los grupos, pero más acentuada en los grupos de <span class="elsevierStyleItalic">cor pulmonale</span> y disfunción diastólica. La correlación entre variables cardía-cas y respiratorias mostró asociación estadísticamente sig-nificativa entre la masa cardíaca y la capacidad vital forza-da (r = 0,34; p de Pearson = 0,02), el volumen espirado en el primer segundo (r = 0,526; p = 0,0001), en volumen espirado en el primer segundo en porcentaje del valor de referencia (r = 0,3; p = 0,037) y el flujo mesoespiratorio forzado (r = 0,31; p = 0,03). También mostraron correlación la fracción de eyección del ventrículo izquierdo y la presión arterial de O<span class="elsevierStyleInf">2</span> (r = -0,312; p = 0,01), así como el diámetro tele-diastólico del ventrículo izquierdo y la presión arterial de O<span class="elsevierStyleInf">2</span> (r = 0,369; p = 0,006).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">La espirometría de pacientes con disfunción cardíaca muestra globalmente un patrón obstructivo, más acentuado en pacientes con disfunción ventricular de-recha al existir patología pulmonar previa. Las asociacio-nes halladas entre variables de función cardíaca y pulmonar no permiten valorar de una forma más precisa la patología predominante en cada paciente ni establecer un pronóstico.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was financed in part by Red Respira (RTIC-ISCIII-SEPAR).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Insuficiencia cardíaca" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E Braunwald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Harrison. Principios de medicina interna" "paginaInicial" => "1552" "paginaFinal" => "1553" "edicion" => "15th ed." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 3 | 7 |
| 2024 October | 31 | 27 | 58 |
| 2024 September | 26 | 32 | 58 |
| 2024 August | 49 | 36 | 85 |
| 2024 July | 27 | 26 | 53 |
| 2024 June | 29 | 22 | 51 |
| 2024 May | 31 | 28 | 59 |
| 2024 April | 15 | 21 | 36 |
| 2024 March | 20 | 20 | 40 |
| 2024 February | 20 | 14 | 34 |
| 2023 June | 0 | 1 | 1 |
| 2023 March | 1 | 1 | 2 |
| 2023 February | 12 | 18 | 30 |
| 2023 January | 14 | 34 | 48 |
| 2022 December | 21 | 29 | 50 |
| 2022 November | 14 | 24 | 38 |
| 2022 October | 19 | 28 | 47 |
| 2022 September | 16 | 28 | 44 |
| 2022 August | 16 | 38 | 54 |
| 2022 July | 20 | 40 | 60 |
| 2022 June | 21 | 27 | 48 |
| 2022 May | 17 | 30 | 47 |
| 2022 April | 19 | 32 | 51 |
| 2022 March | 22 | 31 | 53 |
| 2022 February | 18 | 44 | 62 |
| 2022 January | 14 | 32 | 46 |
| 2021 December | 18 | 48 | 66 |
| 2021 November | 14 | 44 | 58 |
| 2021 October | 19 | 44 | 63 |
| 2021 September | 13 | 53 | 66 |
| 2021 August | 15 | 27 | 42 |
| 2021 July | 13 | 22 | 35 |
| 2021 June | 12 | 42 | 54 |
| 2021 May | 11 | 31 | 42 |
| 2021 April | 41 | 62 | 103 |
| 2021 March | 21 | 30 | 51 |
| 2021 February | 16 | 11 | 27 |
| 2021 January | 8 | 12 | 20 |
| 2020 December | 9 | 16 | 25 |
| 2020 November | 11 | 22 | 33 |
| 2020 October | 13 | 9 | 22 |
| 2020 September | 5 | 8 | 13 |
| 2020 August | 11 | 10 | 21 |
| 2020 July | 10 | 17 | 27 |
| 2020 June | 11 | 6 | 17 |
| 2020 May | 15 | 11 | 26 |
| 2020 April | 16 | 13 | 29 |
| 2020 March | 12 | 19 | 31 |
| 2020 February | 14 | 14 | 28 |
| 2020 January | 11 | 12 | 23 |
| 2019 December | 16 | 19 | 35 |
| 2019 November | 10 | 9 | 19 |
| 2019 October | 9 | 8 | 17 |
| 2019 September | 5 | 8 | 13 |
| 2019 August | 6 | 10 | 16 |
| 2019 July | 10 | 13 | 23 |
| 2019 June | 7 | 6 | 13 |
| 2019 May | 11 | 4 | 15 |
| 2019 April | 37 | 16 | 53 |
| 2019 March | 17 | 18 | 35 |
| 2019 February | 12 | 10 | 22 |
| 2019 January | 10 | 7 | 17 |
| 2018 December | 11 | 11 | 22 |
| 2018 November | 17 | 17 | 34 |
| 2018 October | 17 | 27 | 44 |
| 2018 September | 10 | 14 | 24 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 14 | 6 | 20 |
| 2018 March | 5 | 3 | 8 |
| 2018 February | 7 | 4 | 11 |
| 2018 January | 3 | 8 | 11 |
| 2017 December | 8 | 5 | 13 |
| 2017 November | 3 | 4 | 7 |
| 2017 October | 7 | 5 | 12 |
| 2017 September | 3 | 8 | 11 |
| 2017 August | 3 | 6 | 9 |
| 2017 July | 3 | 5 | 8 |
| 2017 June | 9 | 10 | 19 |
| 2017 May | 7 | 3 | 10 |
| 2017 April | 6 | 1 | 7 |
| 2017 March | 8 | 10 | 18 |
| 2017 February | 2 | 3 | 5 |
| 2017 January | 5 | 5 | 10 |
| 2016 December | 16 | 9 | 25 |
| 2016 November | 13 | 9 | 22 |
| 2016 October | 11 | 13 | 24 |
| 2016 September | 18 | 11 | 29 |
| 2016 August | 9 | 4 | 13 |
| 2016 July | 2 | 3 | 5 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 4 | 0 | 4 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 41 | 1 | 42 |
| 2015 September | 34 | 5 | 39 |
| 2015 August | 22 | 13 | 35 |
| 2015 July | 31 | 9 | 40 |
| 2015 June | 41 | 6 | 47 |
| 2015 May | 41 | 8 | 49 |
| 2015 April | 26 | 8 | 34 |
| 2015 March | 47 | 8 | 55 |
| 2015 February | 30 | 2 | 32 |
| 2015 January | 32 | 6 | 38 |
| 2014 December | 33 | 7 | 40 |
| 2014 November | 32 | 5 | 37 |
| 2014 October | 47 | 8 | 55 |
| 2014 September | 28 | 6 | 34 |
| 2014 August | 28 | 8 | 36 |
| 2014 July | 28 | 6 | 34 |
| 2014 June | 35 | 8 | 43 |
| 2014 May | 39 | 7 | 46 |
| 2014 April | 43 | 6 | 49 |
| 2014 March | 39 | 12 | 51 |
| 2014 February | 39 | 10 | 49 |
| 2014 January | 30 | 5 | 35 |
| 2013 December | 33 | 8 | 41 |
| 2013 November | 18 | 4 | 22 |
| 2013 October | 32 | 6 | 38 |
| 2013 September | 30 | 18 | 48 |
| 2013 August | 17 | 12 | 29 |
| 2013 July | 50 | 10 | 60 |
| 2013 June | 35 | 9 | 44 |
| 2013 May | 27 | 4 | 31 |
| 2013 April | 8 | 4 | 12 |
| 2013 March | 8 | 2 | 10 |
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