Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Alexander, M. S.
Right arrow Articles by Lavender, J. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Alexander, M. S.
Right arrow Articles by Lavender, J. P.

Chest, Vol 101, 1189-1193, Copyright © 1992 by American College of Chest Physicians

ARTICLES

Impaired left lower lobe ventilation in patients with cardiomegaly. An isotope study of mechanisms

MS Alexander, AM Peters, JP Cleland and JP Lavender
Royal Postgraduate Medical School, Hammersmith Hospital, London, England.

Reduced left lower lobe ventilation (V) in patients with enlarged hearts has been commonly observed on routine isotope ventilation- perfusion lung scanning, and there is evidence to show that this reduction is dependent on posture. Clinically, it may have a role in posture-dependent dyspnea and postoperative left lower lobe changes in cardiomegaly. Previous studies have shown improvement in left lower lobe V in the prone compared with the supine position. In 11 patients showing this phenomenon in krypton 81m V scanning, a mean relative reduction in V of 53 percent occurred at the left base. No significant change in perfusion or in the signal from preinjected technetium 99m macroaggregated albumin was observed between the two positions. No significant change in ventilatory turnover (measured with intravenous xenon 133) was seen either, suggesting that no air trapping takes place. By combining the data from the intravenous 133Xe (which gives the ratio, V/lung volume) and continuously inhaled 81mKr (which reflects regional V), an index of relative volume between the two sides was derived and shown to be significantly reduced at the left base on moving from the prone to supine positions (a mean reduction of 40 percent; p less than 0.02 by Wilcoxon signed rank test). Thus, the mechanism of postural left lower lobe hypoventilation in cardiomegaly is predominantly a regional loss of alveolar volume.


This article has been cited by other articles:


Home page
 J. Appl. Physiol.Home page
M. Rohdin, J. Petersson, P. Sundblad, M. Mure, R. W. Glenny, S. G. E. Lindahl, and D. Linnarsson
Effects of gravity on lung diffusing capacity and cardiac output in prone and supine humans
J Appl Physiol, July 1, 2003; 95(1): 3 - 10.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. M. MALBOUISSON, C. J. BUSCH, L. PUYBASSET, Q. LU, P. CLUZEL, J.-J. ROUBY, and the CT Scan ARDS Study Gr
Role of the Heart in the Loss of Aeration Characterizing Lower Lobes in Acute Respiratory Distress Syndrome
Am. J. Respir. Crit. Care Med., June 1, 2000; 161(6): 2005 - 2012.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1992 by the American College of Chest Physicians.