Hong Kong Respiratory Medicine

NEJM, v 362:1638-1641 April 29, 2010 Number 17. Related Article: by Vonk-Noordegraaf, A.; Related Article: by Barr, R. G.

To the Editor: Barr and colleagues (Jan. 21 issue)1 speculate that the subclinical loss of the pulmonary capillary bed in patients with mild emphysema is responsible for left ventricular hypofilling, whereas hyperinflation of the lung has a role in very severe chronic obstructive pulmonary disease (COPD) only.

We found hyperinflation of the lung to have a stronger association with left ventricular end-diastolic diameter than airflow obstruction or the diffusion capacity for carbon monoxide in 138 patients with COPD ranging from mild to very severe.2 Therefore, we assume that hyperinflation has an effect on decreasing pulmonary vascular compliance that is mediated . . . [Full Text of this Article]

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