Pulmonary function in primary pulmonary hypertension

AbstractObjectivesThe study was done to ascertain the degree to which abnormalities in resting lung function correlate with the disease severity of patients with primary pulmonary hypertension (PPH).BackgroundPatients with PPH are often difficult to diagnose until several years after the onset of symptoms. Despite the seriousness of the disorder, the diagnosis of PPH is often delayed because it is unsuspected and requires invasive measurements. Although PPH often causes abnormalities in resting lung function, these abnormalities have not been shown to be statistically significant when correlated with other measures of PPH severity.MethodsResting lung mechanics and diffusing capacity for carbon monoxide DLcowere assessed in 79 patients whose findings conformed to the classical diagnostic criteria of PPH and who had no evidence of secondary causes of pulmonary hypertension. These findings were correlated with severity of disease as assessed by cardiac catheterization, New York Heart Association (NYHA) class, and cardiopulmonary exercise testing.ResultsWhen PPH patients were first evaluated at our referral clinic, the DLcoand lung volumes were decreased in approximately three-quarters and one-half, respectively. The decreases in DLco, and to a lesser extent lung volumes, correlated significantly with decreases in peak oxygen uptake (reflecting maximum cardiac output), peak oxygen pulse (reflecting maximum stroke volume), and anaerobic threshold (reflecting sustainable exercise capacity) and higher NYHA class.ConclusionsPatients with PPH commonly have abnormalities in lung mechanics and DLcolevels that correlate significantly with disease severity. These measurements can be useful in evaluating patients with unexplained dyspnea and fatigue