Pulmonary Vascular Disease |

Bronchial Nitric Oxide Flux Is Decreased in Pulmonary Hypertension FREE TO VIEW

Michela Bellocchia, MD; Antonio Ciuffreda, MD; Alberto Milan, MD; Corrado Magnino, MD; Daniela Libertucci, MD; Lorena Mercante, MD; Walter Grosso Marra, MD; Emanuele Pivetta, MD; Caterina Bucca, MD
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Department of Medical Sciences, University of Turin, Turin, Italy

Chest. 2014;146(4_MeetingAbstracts):850A. doi:10.1378/chest.1994414
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SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters IV

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Impaired endogenous nitric oxide (NO) production has long been speculated as a potential mechanism in pulmonary hypertension. We investigated whether bronchial NO flux (JawNO) and alveolar NO concentration (CalvNO) are related to pulmonary artery pressure (PAP) and transpulmonary gradient (TPG) and may predict pulmonary hypertension (PH).

METHODS: Eighty eight patients scheduled for cardiac catheterization underwent lung function tests, arterial blood gas analysis, exhaled NO with calculation of JawNO and CalvNO, using the slope-intercept model. Patients were divided into 4 groups: no PH (G1), passive postcapillary PH (G2), reactive postcapillary PH (TPG > 12. G3), and precapillary PH (G4).

RESULTS: The patients were 43 men and 45 women, mean age 61 years (SEM 1.4), 9 current and 34 former smokers, 57 (64.8%) with PH. Among PH patients, 47 (53.4%) were in PH WHO groups II-IV and 10 (11.4%) in group I. JawNO was significantly inversely related to sistolic PAP (r=0.301. p=0.005), mean PAP (r=0.25. p=0.018) and TPG (r=0.281. p=0.01) and directly related with FEV1%pred (r=0.25, p=0.02) and TLCO %pred (r=0.377, p<0.0001). Mean PAP was inversely related to TLCO%pred (r=0.39,p<0.0001). CalvNO was not significantly related to PAP, but showed a trend toward an increase with increasing PAP. CalvNO was significantly inversely related to PaO2 (r=0.22,p=0.05) and increased in parallel to the impairment in lung diffusing capacity.

CONCLUSIONS: In pulmonary hypertension NO production is impaired in airway walls and is inversely related to PAP. Alveolar NO is not a good index of PH as it is influenced by the impairment of lung diffusing capacity.

CLINICAL IMPLICATIONS: Our findings indicate that measurement of exhaled NO may be useful in the assessment of pulmonary hypertension.

DISCLOSURE: The following authors have nothing to disclose: Michela Bellocchia, Antonio Ciuffreda, Alberto Milan, Corrado Magnino, Daniela Libertucci, Lorena Mercante, Walter Grosso Marra, Emanuele Pivetta, Caterina Bucca

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