{"doi":"10.1161/01.cir.91.11.2769","title":"Reduced Alveolar–Capillary Membrane Diffusing Capacity in Chronic Heart Failure","abstract":"<jats:p>\n            <jats:italic>Background</jats:italic>\n            The pulmonary diffusing capacity for carbon monoxide (\n            <jats:sc>dlco</jats:sc>\n            ) is reduced in chronic heart failure (CHF) and is an independent predictor of peak exercise oxygen uptake. The pathophysiological basis for this remains unknown. The aim of this study was to partition\n            <jats:sc>DLco</jats:sc>\n            into its membrane conductance (D\n            <jats:sub>M</jats:sub>\n            ) and capillary blood volume components (Vc) and to assess if alveolar–capillary membrane function correlated with functional status, exercise capacity, and pulmonary vascular resistance.\n          </jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results</jats:italic>\n            The classic Roughton and Forster method of measuring single-breath\n            <jats:sc>DLco</jats:sc>\n            at varying alveolar oxygen concentrations was used to determine D\n            <jats:sub>M</jats:sub>\n            and Vc in 15 normal subjects and 50 patients with CHF. All performed symptom-limited maximal bicycle exercise tests with respiratory gas analysis; 15 CHF patients underwent right heart catheterization.\n            <jats:sc>DLco</jats:sc>\n            was significantly reduced in CHF patients compared with normal subjects, predominantly because of a reduction in D\n            <jats:sub>M</jats:sub>\n            (7.0±2.6 versus 12.9±3.8 versus 20.0±6.1 mmol · min\n            <jats:sup>−1</jats:sup>\n            · kPa\n            <jats:sup>−1</jats:sup>\n            in New York Heart Association class III, class II, and normal subjects, respectively,\n            <jats:italic>P</jats:italic>\n            &lt;.0001), even when the reduction in lung volumes was accounted for by the division of D\n            <jats:sub>M</jats:sub>\n            by the effective alveolar volume. The Vc component of\n            <jats:sc>DLco</jats:sc>\n            was not impaired. D\n            <jats:sub>M</jats:sub>\n            significantly correlated with maximal exercise oxygen uptake (\n            <jats:italic>r</jats:italic>\n            =.72,\n            <jats:italic>P</jats:italic>\n            &lt;.0001) and inversely correlated with pulmonary vascular resistance (\n            <jats:italic>r</jats:italic>\n            =.65,\n            <jats:italic>P</jats:italic>\n            &lt;.01) in CHF.\n          </jats:p>\n          <jats:p>\n            <jats:italic>Conclusions</jats:italic>\n            Reduced alveolar–capillary membrane diffusing capacity is the major component of impaired pulmonary gas transfer in CHF, correlating with maximal exercise capacity and functional status. D\n            <jats:sub>M</jats:sub>\n            may be a useful marker for the alveolar–capillary barrier damage induced by raised pulmonary capillary pressure.\n          </jats:p>","journal":"Circulation","year":1995,"id":20552,"datarank":14.018163967362481,"base_score":5.517452896464707,"endowment":5.517452896464707,"self_citation_contribution":0.8276179344697062,"citation_network_contribution":13.190546032892774,"self_endowment_contribution":0.8276179344697062,"citer_contribution":13.190546032892774,"corpus_percentile":null,"corpus_rank":null,"citation_count":248,"citer_count":200,"citers_with_citation_signal":200,"citers_with_endowment":200,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":135446,"name":"B. Leigh Baker","orcid":null,"position":1,"is_corresponding":false},{"id":135447,"name":"David P. Dutka","orcid":null,"position":2,"is_corresponding":false},{"id":135448,"name":"Celia M. Oakley","orcid":null,"position":3,"is_corresponding":false},{"id":135449,"name":"J. Michael B. Hughes","orcid":null,"position":4,"is_corresponding":false},{"id":135450,"name":"John G. F. Cleland","orcid":null,"position":5,"is_corresponding":false},{"id":135445,"name":"Sundeep Puri","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"base_score":5.517452896464707,"endowment":5.517452896464707,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"7758183","pmcid":null,"openalex_id":"https://openalex.org/W2097686700","authors":[],"funders":[],"total_grants":0,"fwci":13.8087,"citation_percentile":0.9911967,"influential_citations":6,"citation_trend":[{"year":2012,"count":9},{"year":2013,"count":12},{"year":2014,"count":9},{"year":2015,"count":5},{"year":2016,"count":9},{"year":2017,"count":5},{"year":2018,"count":3},{"year":2019,"count":8},{"year":2020,"count":5},{"year":2021,"count":5},{"year":2022,"count":9},{"year":2023,"count":7},{"year":2024,"count":5},{"year":2025,"count":5},{"year":2026,"count":2}],"oa_status":"closed","license":null,"oa_locations":[{"url":"https://www.ahajournals.org/doi/full/10.1161/01.CIR.91.11.2769","host_type":"publisher"},{"url":"https://doi.org/10.1161/01.cir.91.11.2769","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/7758183","host_type":"repository"}],"fields_of_study":["Cardiovascular and exercise physiology","Chronic Obstructive Pulmonary Disease (COPD) Research","Cardiovascular Function and Risk Factors","Medicine","Blood-Air Barrier","Capillary Permeability","Cardiac Catheterization","Case-Control Studies","Exercise Test","Exercise Tolerance","Female","Heart Failure","Humans","Lung Volume Measurements","Male","Middle Aged","Pulmonary Circulation","Pulmonary Diffusing Capacity","Pulmonary Gas Exchange","Vascular Resistance"],"mesh_terms":["Capillary Permeability","Exercise Test","Female","Cardiac Catheterization","Heart Failure","Humans","Lung Volume Measurements","Male","Middle Aged","Pulmonary Circulation","Pulmonary Diffusing Capacity","Pulmonary Gas Exchange","Vascular Resistance","Blood-Air Barrier","Case-Control Studies","Exercise Tolerance"],"keywords":["Medicine","Heart failure","Cardiology","Internal medicine","Capillary action"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Clean water and sanitation"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-06-05T23:05:11.467528Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}