Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.

Intrapulmonary arteriovenous anastomoses (IPAVs) are large diameter connections that allow blood to bypass the lung capillaries and may provide a route for right-to-left embolus transmission. These anastomoses are recruited by exercise and catecholamines and hypoxia. Yet, whether IPAVs are recruited...

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Autores principales:	Melissa L Bates, Emily T Farrell, Alyssa Drezdon, Joseph E Jacobson, Scott B Perlman, Marlowe W Eldridge
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d43fefe268a74a29b4db3caa63976b44
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spelling	oai:doaj.org-article:d43fefe268a74a29b4db3caa63976b442021-11-25T06:08:47ZHypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.1932-620310.1371/journal.pone.0101146https://doaj.org/article/d43fefe268a74a29b4db3caa63976b442014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25013985/?tool=EBIhttps://doaj.org/toc/1932-6203Intrapulmonary arteriovenous anastomoses (IPAVs) are large diameter connections that allow blood to bypass the lung capillaries and may provide a route for right-to-left embolus transmission. These anastomoses are recruited by exercise and catecholamines and hypoxia. Yet, whether IPAVs are recruited via direct, oxygen sensitive regulatory mechanisms or indirect effects secondary to redistribution pulmonary blood flow is unknown. Here, we hypothesized that the addition of exercise to hypoxic gas breathing, which increases cardiac output, would augment IPAVs recruitment in healthy humans. To test this hypothesis, we measured the transpulmonary passage of 99mTc-macroaggregated albumin particles (99mTc-MAA) in seven healthy volunteers, at rest and with exercise at 85% of volitional max, with normoxic (FIO2 = 0.21) and hypoxic (FIO2 = 0.10) gas breathing. We found increased 99mTc-MAA passage in both exercise conditions and resting hypoxia. However, contrary to our hypothesis, we found the greatest 99mTc-MAA passage with resting hypoxia. As an additional, secondary endpoint, we also noted that the transpulmonary passage of 99mTc-MAA was well-correlated with the alveolar-arterial oxygen difference (A-aDO2) during exercise. While increased cardiac output has been proposed as an important modulator of IPAVs recruitment, we provide evidence that the modulation of blood flow through these pathways is more complex and that increasing cardiac output does not necessarily increase IPAVs recruitment. As we discuss, our data suggest that the resistance downstream of IPAVs is an important determinant of their perfusion.Melissa L BatesEmily T FarrellAlyssa DrezdonJoseph E JacobsonScott B PerlmanMarlowe W EldridgePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e101146 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Melissa L Bates Emily T Farrell Alyssa Drezdon Joseph E Jacobson Scott B Perlman Marlowe W Eldridge Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.
description	Intrapulmonary arteriovenous anastomoses (IPAVs) are large diameter connections that allow blood to bypass the lung capillaries and may provide a route for right-to-left embolus transmission. These anastomoses are recruited by exercise and catecholamines and hypoxia. Yet, whether IPAVs are recruited via direct, oxygen sensitive regulatory mechanisms or indirect effects secondary to redistribution pulmonary blood flow is unknown. Here, we hypothesized that the addition of exercise to hypoxic gas breathing, which increases cardiac output, would augment IPAVs recruitment in healthy humans. To test this hypothesis, we measured the transpulmonary passage of 99mTc-macroaggregated albumin particles (99mTc-MAA) in seven healthy volunteers, at rest and with exercise at 85% of volitional max, with normoxic (FIO2 = 0.21) and hypoxic (FIO2 = 0.10) gas breathing. We found increased 99mTc-MAA passage in both exercise conditions and resting hypoxia. However, contrary to our hypothesis, we found the greatest 99mTc-MAA passage with resting hypoxia. As an additional, secondary endpoint, we also noted that the transpulmonary passage of 99mTc-MAA was well-correlated with the alveolar-arterial oxygen difference (A-aDO2) during exercise. While increased cardiac output has been proposed as an important modulator of IPAVs recruitment, we provide evidence that the modulation of blood flow through these pathways is more complex and that increasing cardiac output does not necessarily increase IPAVs recruitment. As we discuss, our data suggest that the resistance downstream of IPAVs is an important determinant of their perfusion.
format	article
author	Melissa L Bates Emily T Farrell Alyssa Drezdon Joseph E Jacobson Scott B Perlman Marlowe W Eldridge
author_facet	Melissa L Bates Emily T Farrell Alyssa Drezdon Joseph E Jacobson Scott B Perlman Marlowe W Eldridge
author_sort	Melissa L Bates
title	Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.
title_short	Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.
title_full	Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.
title_fullStr	Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.
title_full_unstemmed	Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.
title_sort	hypoxia and exercise increase the transpulmonary passage of 99mtc-labeled albumin particles in humans.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/d43fefe268a74a29b4db3caa63976b44
work_keys_str_mv	AT melissalbates hypoxiaandexerciseincreasethetranspulmonarypassageof99mtclabeledalbuminparticlesinhumans AT emilytfarrell hypoxiaandexerciseincreasethetranspulmonarypassageof99mtclabeledalbuminparticlesinhumans AT alyssadrezdon hypoxiaandexerciseincreasethetranspulmonarypassageof99mtclabeledalbuminparticlesinhumans AT josephejacobson hypoxiaandexerciseincreasethetranspulmonarypassageof99mtclabeledalbuminparticlesinhumans AT scottbperlman hypoxiaandexerciseincreasethetranspulmonarypassageof99mtclabeledalbuminparticlesinhumans AT marloweweldridge hypoxiaandexerciseincreasethetranspulmonarypassageof99mtclabeledalbuminparticlesinhumans
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Hypoxia and exercise increase the transpulmonary passage of 99mTc-labeled albumin particles in humans.

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