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Model‐Based Estimation of Pulmonary Flow Heterogeneity from Observed Oxygen Transport Parameters in Exercise
Author(s) -
Roy Tuhin K.,
Secomb Timothy W.
Publication year - 2018
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2018.32.1_supplement.704.1
Subject(s) - pulmonary diffusing capacity , diffusing capacity , perfusion , oxygen transport , ventilation (architecture) , oxygen , lung , blood flow , vo2 max , cardiology , medicine , chemistry , oxygenation , lung function , thermodynamics , heart rate , blood pressure , physics , organic chemistry
The rate at which oxygen can be taken up into the bloodstream in the lung is a critical determinant of functional capacity, and can be affected by heterogeneity of pulmonary blood flow (leading to maldistribution and poor ventilation‐perfusion matching) as well as alterations in diffusing capacity. Under resting conditions, the high degree of reserve in the healthy lung leads to adequate oxygen uptake even in the face of increased heterogeneity or decreased diffusing capacity; under conditions of exercise, however, oxygen transport and utilization are contingent upon adequate lung function with relatively little reserve. A mathematical model of pulmonary oxygen uptake is used in this study to investigate the impact of pulmonary flow heterogeneity in exercise, which we characterize by the coefficient of variation (CV) of pulmonary capillary blood flow; under conditions of uniform alveolar ventilation, this is theoretically equivalent to impaired ventilation‐perfusion matching. We have previously demonstrated that any level of pulmonary heterogeneity up to a high degree (CV of approximately 3.0) is consistent with the observed level of arterial oxygen tension under resting conditions. We hypothesize that such high levels of heterogeneity would preclude the high oxygen uptake in the lung observed during exercise. In this study, literature data on humans under normoxic and hypoxic conditions was used to estimate the CV of pulmonary capillary blood flow under conditions of moderate and extreme exercise. With the assumption of a normal diffusing capacity, the best fit overall to aggregated data from five studies was found with a CV of 0.61. These results show that a high degree of pulmonary flow heterogeneity does not limit oxygen uptake at rest, but that in exercise much lower levels of heterogeneity are necessary to achieve observed oxygen fluxes. An important mechanism for reducing heterogeneity is flow regulation via hypoxic pulmonary vasoconstriction (HPV), which is activated at the low levels of venous oxygen tension in exercise. The results suggest that HPV plays an essential role in allowing high levels of pulmonary oxygen uptake in exercise. Support or Funding Information Supported by NIH U01 HL133362 This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .