Lung fluid clearance in chronic heart failure patients

Dani Louise Dixon, Carmine G. De Pasquale, Mark D. Lawrence, Elena Cavallaro, Vito Rubino, Andrew D. Bersten

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Chronic elevation of pulmonary microvascular pressure (Pmv) consistently leads to alveolocapillary barrier thickening and reduction in the filtration coefficient. In animal models of chronic heart failure (CHF) the lung remains dry despite hydrostatic forces. As fluid flux is bi-directional, it has been postulated that an increase in alveolar fluid clearance may facilitate the dry lung when Pmv is chronically elevated. In this study we aimed to examine alveolar fluid clearance in ambulatory patients with CHF secondary to left ventricular (LV) systolic dysfunction compared against non-CHF controls. Lung clearance following aerosol delivery of 99mtechnetium (Tc)-diethyl triaminepentaacetic acid (DTPA) was measured non-invasively by scintigraphy and half time of 99mTc-DTPA clearance (T (1/2)) was calculated by mono-exponential curve fit. Alveolar fluid clearance measured as half time DTPA clearance was significantly faster in CHF patients than controls (P = 0.001). This was further defined by NYHA classification. No correlation was found between DTPA clearance and plasma epinephrine, norepinephrine or aldosterone hormone (P > 0.05). Our results support an association between increasing alveolar fluid clearance and disease severity in CHF, and the concept of controlled bi-directional fluid flux in CHF associated with increasing Pmv, and represents another defence mechanism of the lung against pulmonary oedema.

    Original languageEnglish
    Pages (from-to)245-247
    Number of pages3
    JournalInternational Journal of Cardiology
    Volume244
    Early online date26 May 2017
    DOIs
    Publication statusPublished - 1 Oct 2017

    Keywords

    • Aerosol scintigraphy
    • Catecholamines
    • Chronic heart failure
    • Pulmonary fluid clearance

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