Key result
Simulations of inspiratory loading in older subjects identified a linear increase of left ventricular transmural pressures with negative intrathoracic pressure that was nearly 38% larger than in younger subjects.
Why the study?
How does age affect cardiopulmonary interaction and arterial blood pressure during airway obstruction?
How does age affect cardiopulmonary interaction and arterial blood pressure during airway obstruction?
The apparent preservation of arterial blood pressure during airway obstruction in the elderly reflects increased afterload and diastolic dysfunction rather than preserved perfusion.
Answers are grounded in this paper and cite their sources.
Age-related attenuation of inspiratory Pa drop may reflect specific interactions; modeling extends mechanistic insight but leaves clinical relevance open.
Inspiratory fall in arterial blood pressure (Pa) during airway obstruction was ascribed to ventricular interdependence, afterload, and transmission of intrathoracic pressure swings. We have shown this effect significantly reduced in the elderly, but the underlying reasons remain unclear. Here we compare the results of inspiratory loading in young and older subjects with a mathematical model that simulated beat-by-beat fluctuations in cardiopulmonary variables. By increasing arterial and left ventricular elastance parameters in the older group, simulations strongly correlated with the experimental Pa and identified a linear increase of left ventricular transmural pressures with negative intrathoracic pressure that was nearly 38% larger than that in the younger group. The apparent perfusion preservation by less Pa decline with obstruction in the elderly could be misleading, since it reflects an increased afterload and diastolic dysfunction.
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Ernesto Goldman (2010) studied Airway obstruction. Inspiratory loading vs. Younger subjects was evaluated on Left ventricular transmural pressures with negative intrathoracic pressure (38% larger increase). Simulations of inspiratory loading in older subjects identified a linear increase of left ventricular transmural pressures with negative intrathoracic pressure that was nearly 38% larger than in younger subjects.
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