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High-Resolution CT Scan in the Evaluation of Exercise-Induced Interstitial Pulmonary Edema in Cardiac Patients

Francisco C. Brasileiro; Francisco S. Vargas; Jorge I. Kavakama; João J. Leite; Alberto Cukier; Christian Préfaut
Author and Funding Information

From the Instituto do Coração of the Faculty of Medicine of the University of Sao Paulo, Brazil, and the Laboratoire D'Exploration Fonctionnelle et Respiratoire, Montpellier, France


1997 by the American College of Chest Physicians


Chest. 1997;111(6):1577-1582. doi:10.1378/chest.111.6.1577
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Abstract

Objective: To evaluate the onset of exercise-induced interstitial pulmonary edema in cardiac patients by high-resolution CT (HRCT).

Design: Prospective, normal controlled.

Participants: Thirty subjects divided into three groups: group 1—10 outpatients with chronic congestive heart failure (CCHF), New York Heart Association (NYHA) class I; group 2—10 outpatients with CCHF, NYHA class II/III; and group 3 (control)—10 normal subjects.

Method: HRCT scans were obtained at rest and 4, 8, 12, 16, and 20 min after progressive treadmill exercise test.

Results: The following HRCT findings consistent with interstitial edema were significantly different (p<0.05) in group 2 when compared with groups 1 and 3: artery/bronchus ratio >1 in the upper lobes, peripheral increase in the vascular markings, interlobular septal thickening, and peribronchial "cuffing." These differences were maximal at 12 min after exercise and returned to normal values after 20 min.

Conclusion: Interstitial pulmonary edema was present immediately after exercise in CCHF patients. It may be important in the genesis of dyspnea of these patients.


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