Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

The European Respiratory Journal
Denis ChemlaPhilippe Hervé

Abstract

Right ventricular adaptation to the increased pulmonary arterial load is a key determinant of outcomes in pulmonary hypertension (PH). Pulmonary vascular resistance (PVR) and total arterial compliance (C) quantify resistive and elastic properties of pulmonary arteries that modulate the steady and pulsatile components of pulmonary arterial load, respectively. PVR is commonly calculated as transpulmonary pressure gradient over pulmonary flow and total arterial compliance as stroke volume over pulmonary arterial pulse pressure (SV/PApp). Assuming that there is an inverse, hyperbolic relationship between PVR and C, recent studies have popularised the concept that their product (RC-time of the pulmonary circulation, in seconds) is "constant" in health and diseases. However, emerging evidence suggests that this concept should be challenged, with shortened RC-times documented in post-capillary PH and normotensive subjects. Furthermore, reported RC-times in the literature have consistently demonstrated significant scatter around the mean. In precapillary PH, the true PVR can be overestimated if one uses the standard PVR equation because the zero-flow pressure may be significantly higher than pulmonary arterial wedge pressure. Furthermo...Continue Reading

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Citations

Jul 15, 2017·Critical Care Medicine·Thomas S MetkusRyan J Tedford
Jun 22, 2019·American Journal of Physiology. Heart and Circulatory Physiology·Junjing SuSoren Mellemkjaer
Nov 15, 2019·Current Opinion in Anaesthesiology·Theresa GelzinisAlbert C Perrino
Jun 9, 2016·Current Opinion in Pulmonary Medicine·Edmund M LauPhilippe Herve
Sep 15, 2020·Pulmonary Circulation·Zhongkai ZhuJiwang Chen
Sep 27, 2019·Pulmonary Circulation·Maria F ZorziLucas Liaudet
Dec 29, 2020·American Journal of Physiology. Heart and Circulatory Physiology·S P WrightS Mak
May 9, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Ghaleb KhirfanAdriano R Tonelli
Jun 5, 2021·ERJ Open Research·Denis ChemlaPhilippe Hervé

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