PT -期刊文章盟Lorenzi-Filho g . AU - Azevedo, E.R. AU - Parker, J.D. AU - Bradley, T.D. TI - Relationship of carbon dioxide tension in arterial blood to pulmonary wedge pressure in heart failure AID - 10.1183/09031936.02.00214502 DP - 2002 Jan 01 TA - European Respiratory Journal PG - 37--40 VI - 19 IP - 1 4099 - //www.qdcxjkg.com/content/19/1/37.short 4100 - //www.qdcxjkg.com/content/19/1/37.full SO - Eur Respir J2002 Jan 01; 19 AB - Hypocapnia contributes to the genesis of Cheyne-Stokes respiration and central sleep apnoea in patients with congestive heart failure (CHF) and is associated with increased mortality. However, the cause of hypocapnia in patients with chronic stable CHF is unknown. Since pulmonary congestion can induce hyperventilation via stimulation of pulmonary vagal afferents, the present study tested the hypothesis that in patients with CHF (carbon dioxide tension in arterial blood (Pa,CO2)) is inversely related to pulmonary capillary wedge pressure (PCWP), and that alterations in PCWP would cause inverse changes in Pa,CO2. In 11 CHF patients undergoing diagnostic cardiac catheterization, haemodynamic variables and arterial blood gas tensions were measured simultaneously at baseline. In three patients, these measurements were repeated after coronary angiographic dye infusion and nitroglycerine infusion. At baseline, Pa,CO2 correlated inversely with PCWP (r=−0.80, p=0.003). In the three patients in whom multiple measurements were made, acute alterations in PCWP caused inversely proportional changes in Pa,CO2. The present study concludes that in patients with congestive heart failure, pulmonary capillary wedge pressure is an important determinant of carbon dioxide tension in arterial blood. These findings imply that hypocapnia in patients with chronic stable congestive heart failure is a respiratory manifestation of elevated left ventricular filling pressures. The present study was supported by grants from the Canadian Institutes of Health Research (MOP-11607) and from the Heart and Stroke Foundation of Ontario. G. Lorenzi-Filho was supported by research fellowships from Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, Brazil and the Dept of Medicine of the University of Toronto. E.R. Azevedo held a research fellowship from Astra Zeneca/Heart and Stroke Foundation of Canada. T.D. Bradley is a Senior Scientist of the Canadian Institutes of Health Research.