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(Circulation. 1974;49:115.)
© 1974 American Heart Association, Inc.

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Lung Water in Patients with Acute Myocardial Infarction

THEODORE L. BIDDLE M.D.¹; PURSHOTTAM K. KHANNA M.D.¹; PAUL N. YU M.D.¹; MORRISON HODGES M.D.¹; PRAVIN M. SHAH M.D.¹

¹ From the Cardiology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry and Strong Memorial Hospital, Rochester, New York.

Pulmonary extravascular water volume (PEV) or lung water was measured in 45 patients with acute myocardial infarction, utilizing the double radioisotope indicator dilution technique. A PEV greater than the upper limit or normal (120 ml/m²) was found in 27 patients, 23 of whom had an elevated pulmonary wedge or pulmonary artery diastolic pressure. A significant correlation was found between PEV and pulmonary wedge or pulmonary diastolic pressure in the whole series. A progressive increase in average PEV was observed from Class I (uncomplicated) to Class IV (shock) patients. There was also a progressive increase in PEV from patients with normal chest X-ray findings to those with radiologic evidence of acute pulmonary edema. In seven of 11 patients with initial elevation of both PEV and pulmonary wedge pressure, repeat determinations demonstrated a substantial reduction in both parameters over a period of 2-4 days.

We postulate that an increased PEV in patients with acute myocardial infarction is largely due to an elevated pulmonary capillary pressure. The latter is probably a consequence of an elevated left ventricular diastolic pressure, which may be a manifestation of either left ventricular failure or a decrease in left ventricular compliance.

Key Words: Pulmonary extravascular water volume • Pulmonary wedge pressure • Hemodynamics • Cardiac index • Plasma volume • Total blood volume • Pulmonary edema

Submitted on July 27, 1973
Accepted on September 12, 1973