Role of circulatory congestion in the cardiorespiratory failure of obesity

摘要: The role of circulatory congestion in the cardiorespiratory dysfunction massive obesity was investigated 18 patients. They were hypervolemic and had increased cardiac outputs proportionate to their weight. average resting left ventricular filling pressure within upper limits normal, but it abnormally high levels with venous return passive leg raising, further during exercise. elevations associated central blood volumes which significantly exertion. These findings are consistent reduced distensibility circulation these congested Weight reduction accompanied by a decrease restoration normal response three four patients toward one. improvement function relief edema dyspnea. In 14 or only minimal alveolar hypoventilation, there no significant transpulmonary diastolic gradients despite marked increase end-diastolic pressures. One patient, after regaining weight, subsequently an abnormal gas exchange pulmonary vascular resistance. He two others severe hypoventilation demonstrated cor pulmonale on background circulation. Two other patients, least obese group, Hypervolemia hyperdynamic state common features High output is maintained may result generalized anasarca This clinical syndrome be present without intrinsic heart disease reversible weight reduction. contribute development certain