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Lung fluid balance in patients with heart failure: effect of beta‐2 adrenergic‐receptor stimulation
Author(s) -
Taylor Bryan,
Ceridon Maile,
Snyder Eric,
Carlson Alex,
Hulsebus Minelle,
Johnson Bruce
Publication year - 2011
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.25.1_supplement.1045.5
Subject(s) - dlco , lung , medicine , stimulation , heart failure , agonist , inhalation , cardiology , lung volumes , endocrinology , anesthesia , receptor , diffusing capacity , lung function
Background β 2 ‐adrenergic receptor (β 2 AR) stimulation promotes lung fluid removal in animals and healthy humans. It is possible that lung fluid accumulation in heart failure (HF) patients is caused by impairment in lung fluid regulation via desensitization of the lung β 2 ARs. Purpose To determine the effect of an acute inhaled β 2 AR agonist on lung fluid in HF. Methods/Results 22 stable HF patients and 22 healthy age and gender matched subjects were studied. Lung fluid was estimated at baseline (BL) and up to 30 min after administration of nebulized albuterol by measuring lung diffusing capacity for CO (DLCO), alveolar‐capillary conductance (Dm) and pulmonary capillary blood volume (Vc) using a rebreathe method. Pre‐inhalation, DLCO was not different in HF vs . healthy subjects (16±5 vs . 19±4 ml/min/mmHg, P =0.06). By contrast, Dm/Vc was greater in HF vs . healthy subjects (0.42 ± 0.14 vs . 0.33 ± 0.15, P =0.04). In HF, group mean DLCO, Dm and Dm/Vc were not different pre‐ vs. post‐albuterol. However, patients who had an increase in DLCO and Dm/Vc with albuterol administration had significantly lower BL values compared to patients who had no improvement ( P <0.05). That is, β 2 AR stimulation improved DLCO and Dm/Vc only in subjects who had evidence for increased lung fluid at BL. Conclusion Stimulation of β 2 AR may stimulate fluid removal in stable HF patients who exhibit evidence for elevated lung water at rest. HL71478.