Journal Article

Hematocrit-corrected Pulmonary Vascular Resistance

Vanderpool, Rebecca R., Naeije, Robert

2018

Overview

Hematocrit was much higher in Andeans, but hematocrit-corrected total PVR was not. [...]contrary to current belief (17), different adaptations to permanent life at high altitude in South American versus Himalayan populations may not clearly include intrinsic differences in the pulmonary circulation. With a PAWP of 15 mm Hg, which is more realistic as high CO in anemia tends to be associated with increased PAWP, a hematocrit-corrected PVR becomes 4.9 WU (Figure 1). [...]in cases of a higherthan-normal PAWP, PVR even lower than 2 WU may or may not reflect abnormal pulmonary vascular tone and structure suggestive of pulmonary vascular disease in patients with SCD. [...]the PVR equation can be improved by incorporation of a resistive vessel distensibility coefficient a, which defines the percentage increase in vessel diameter per mm Hg: ... Pulmonary vascular disease even at the earliest stages is associated with a loss of pulmonary resistive vessel distensibility, and a decreases to values equal or close to 0%/mm Hg (26, 27). [...]in patients with anemia or polycythemia with borderline pulmonary hypertension (that is, with mPAP or PVR at the upper limit of normal or slightly above), or with established pulmonary hypertension hematocrit corrections of PVR, would follow tightly the predictions of the diagrams presented in Figures 1 and 2.

• Publisher: Oxford University Press
• Subject: Anemia / Anemia, Sickle Cell - physiopathology / Blood / Erythrocytes / Hematocrit / Humans / Hypertension, Pulmonary - complications / Hypertension, Pulmonary - physiopathology / Hypoxia / Nitric oxide / Polycythemia - complications / Polycythemia - physiopathology / Pulmonary arteries / Pulmonary Artery - physiopathology / Pulmonary hypertension / Sickle cell disease / Vascular Resistance - physiology