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The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging

Alveolar‐capillary surface area for pulmonary gas exchange falls with aging, causing a reduction in lung diffusing capacity for carbon monoxide (DLCO). However, during exercise additional factors may influence DLCO, including pulmonary blood flow and pulmonary vascular pressures. First, we sought to...

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Main Authors: Coffman, Kirsten E., Curry, Timothy B., Dietz, Niki M., Chase, Steven C., Carlson, Alex R., Ziegler, Briana L., Johnson, Bruce D.
Format: Online Article Text
Language:English
Published: John Wiley and Sons Inc. 2018
Subjects:
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789722/
https://www.ncbi.nlm.nih.gov/pubmed/29368799
http://dx.doi.org/10.14814/phy2.13565
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author Coffman, Kirsten E.
Curry, Timothy B.
Dietz, Niki M.
Chase, Steven C.
Carlson, Alex R.
Ziegler, Briana L.
Johnson, Bruce D.
author_facet Coffman, Kirsten E.
Curry, Timothy B.
Dietz, Niki M.
Chase, Steven C.
Carlson, Alex R.
Ziegler, Briana L.
Johnson, Bruce D.
author_sort Coffman, Kirsten E.
collection PubMed
description Alveolar‐capillary surface area for pulmonary gas exchange falls with aging, causing a reduction in lung diffusing capacity for carbon monoxide (DLCO). However, during exercise additional factors may influence DLCO, including pulmonary blood flow and pulmonary vascular pressures. First, we sought to determine the age‐dependent effect of incremental exercise on pulmonary vascular pressures and DLCO. We also aimed to investigate the dependence of DLCO on pulmonary vascular pressures during exercise via sildenafil administration to reduce pulmonary smooth muscle tone. Nine younger (27 ± 4 years) and nine older (70 ± 3 years) healthy subjects performed seven 5‐min exercise stages at rest, 0 (unloaded), 10, 15, 30, 50, and 70% of peak workload before and after sildenafil. DLCO, cardiac output (Q), and pulmonary artery and wedge pressure (mPAP and mPCWP; subset of participants) were collected at each stage. mPAP was higher (P = 0.029) and DLCO was lower (P = 0.009) throughout exercise in older adults; however, the rate of rise in mPAP and DLCO with increasing Q was not different. A reduction in pulmonary smooth muscle tone via sildenafil administration reduced mPAP, mPCWP, and the transpulmonary gradient (TPG = mPAP–mPCWP) in younger and older subjects (P < 0.001). DLCO was reduced following the reduction in mPAP and TPG, regardless of age (P < 0.001). In conclusion, older adults successfully adapt to age‐dependent alterations in mPAP and DLCO. Furthermore, DLCO is dependent on pulmonary vascular pressures, likely to maintain adequate pulmonary capillary recruitment. The rise in pulmonary artery pressure with aging may be required to combat pulmonary vascular remodeling and maintain lung diffusing capacity, particularly during exercise.
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spelling pubmed-57897222018-02-08 The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging Coffman, Kirsten E. Curry, Timothy B. Dietz, Niki M. Chase, Steven C. Carlson, Alex R. Ziegler, Briana L. Johnson, Bruce D. Physiol Rep Original Research Alveolar‐capillary surface area for pulmonary gas exchange falls with aging, causing a reduction in lung diffusing capacity for carbon monoxide (DLCO). However, during exercise additional factors may influence DLCO, including pulmonary blood flow and pulmonary vascular pressures. First, we sought to determine the age‐dependent effect of incremental exercise on pulmonary vascular pressures and DLCO. We also aimed to investigate the dependence of DLCO on pulmonary vascular pressures during exercise via sildenafil administration to reduce pulmonary smooth muscle tone. Nine younger (27 ± 4 years) and nine older (70 ± 3 years) healthy subjects performed seven 5‐min exercise stages at rest, 0 (unloaded), 10, 15, 30, 50, and 70% of peak workload before and after sildenafil. DLCO, cardiac output (Q), and pulmonary artery and wedge pressure (mPAP and mPCWP; subset of participants) were collected at each stage. mPAP was higher (P = 0.029) and DLCO was lower (P = 0.009) throughout exercise in older adults; however, the rate of rise in mPAP and DLCO with increasing Q was not different. A reduction in pulmonary smooth muscle tone via sildenafil administration reduced mPAP, mPCWP, and the transpulmonary gradient (TPG = mPAP–mPCWP) in younger and older subjects (P < 0.001). DLCO was reduced following the reduction in mPAP and TPG, regardless of age (P < 0.001). In conclusion, older adults successfully adapt to age‐dependent alterations in mPAP and DLCO. Furthermore, DLCO is dependent on pulmonary vascular pressures, likely to maintain adequate pulmonary capillary recruitment. The rise in pulmonary artery pressure with aging may be required to combat pulmonary vascular remodeling and maintain lung diffusing capacity, particularly during exercise. John Wiley and Sons Inc. 2018-01-25 /pmc/articles/PMC5789722/ /pubmed/29368799 http://dx.doi.org/10.14814/phy2.13565 Text en © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Coffman, Kirsten E.
Curry, Timothy B.
Dietz, Niki M.
Chase, Steven C.
Carlson, Alex R.
Ziegler, Briana L.
Johnson, Bruce D.
The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
title The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
title_full The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
title_fullStr The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
title_full_unstemmed The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
title_short The influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
title_sort influence of pulmonary vascular pressures on lung diffusing capacity during incremental exercise in healthy aging
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789722/
https://www.ncbi.nlm.nih.gov/pubmed/29368799
http://dx.doi.org/10.14814/phy2.13565
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