Abstract

SANTOS-MARTINEZ, Luis-Efren et al. Impact of the deep breathing maneuver in the gas exchange in the subject with severe obesity and pulmonary arterial hypertension associated to Eisenmenger's syndrome. Arch. Cardiol. Méx. [online]. 2008, vol.78, n.3, pp.265-272. ISSN 1665-1731.

Obesity and Eisenmenger's syndrome are entities widely studied. However, its association is unusual and has not been reported. A wide range of gas exchange abnormalities have been describe in both groups. In the severe obese patients this abnormalities are attributed to a ventilation/perfusion mismatch and to an increase pulmonary venous-arterial shunt, that correlates with the lung volume. In severe obese patients with the Eisenmenger's syndrome, this correlation is unknown. Methods: We studied 28 obese subjects paired by body mass index > 30 kg/m². Assigned to two groups, obese with Eisenmenger's syndrome and obese without the syndrome. Clinical variables, respiratory function, echocardiography and gas exchange pre and post-deep breathing maneuver were obtained. Statistical analysis: The variables are expressed with mean±standard deviation. Student t test for paired groups and Pearson correlation coefficient were gathered for the differences and associations between groups. A p-value <0.05 was considered significant. Result: Age was 48.57 ± 10.32 vs 60.86 ± 10.47 y.o. respectively, p < 0.004. Systolic pulmonary arterial pressure 104.36 ± 37 vs 50.1 ± 12 mm Hg, p < 0.001. The arterial oxygen pressure at rest and during the deep breathing maneuver in each group was: 51.64 ± 6.38 vs 57.14 ± 11, p < 0.188 and 56.29 ± 11.15 vs 72 ± 11.83, p < 0.001; venous-arterial shunt 12.79 ± 3.66 vs 13.07 ±4.84, p< 0.767 and 9.21 ±3.77 vs 6.5 ± 2.28, p < 0.001; alveolar arterial oxygen difference 271.14 ± 79.92 vs 243.79 ± 92.07, p < 0.001, respectively. Conclusion: Obese subjects with Eisenmenger's syndrome, did not have significant improvement of gas exchange with the deep breathing maneuver.

Keywords : Gas exchange; Deep breathing; Congenital heart disease.