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All these conditions are associated with a decrease in both arterial P<jats:sc>o<\/jats:sc><jats:sub>2<\/jats:sub>and P<jats:sc>co<\/jats:sc><jats:sub>2<\/jats:sub>. Gas exchange in pulmonary vascular diseases with increased PVR is characterized by a shift of ventilation and perfusion to high ventilation\u2010perfusion ratios, a mild to moderate increase in perfusion to low ventilation\u2010perfusion ratios, and an increased physiologic dead space. Hypoxemia in these patients is essentially explained by altered ventilation\u2010perfusion matching amplified by a decreased mixed venous P<jats:sc>o<\/jats:sc><jats:sub>2<\/jats:sub>caused by a low cardiac output. Hypocapnia is accounted for by hyperventilation, which is essentially related to an increased chemosensitivity. A cardiac shunt on a patent foramen ovale may be a cause of severe hypoxemia in a proportion of patients with pulmonary hypertension and an increase in right atrial pressure. Gas exchange in pulmonary arteriovenous malformations is characterized by variable degree of pulmonary shunting and\/or diffusion\u2010perfusion imbalance. Hypocapnia is caused by an increased ventilation in relation to an increased pulmonary blood flow with direct peripheral chemoreceptor stimulation by shunted mixed venous blood flow. \u00a9 2011 American Physiological Society.<jats:italic>Compr Physiol<\/jats:italic>1:593\u2010619, 2011.<\/jats:p>","DOI":"10.1002\/cphy.c090014","type":"other","created":{"date-parts":[[2011,4,1]],"date-time":"2011-04-01T22:25:22Z","timestamp":1301696722000},"page":"593-619","source":"Crossref","is-referenced-by-count":39,"title":["Pulmonary Vascular Diseases"],"prefix":"10.1002","author":[{"given":"C.","family":"M\u00e9lot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Naeije","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,4]]},"reference":[{"key":"e_1_2_8_2_1_1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1056\/NEJM199608293350901","article-title":"Appetite\u2010suppressant drugs and the risk of primary pulmonary hypertension. 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