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In 118 patients with AMI (ejection fraction \u226550% and wedge pulmonary pressure &lt;16 mmHg), admission alveolar-capillary gas diffusing membrane conductance (DM) averaged 35.1 ml\u00b7min<jats:sup>\u22121<\/jats:sup>\u00b7mmHg<jats:sup>\u22121<\/jats:sup> and was 27% lower than in 25 controls ( P &lt; 0.01). Infusion of saline in the pulmonary circulation (to test sodium exchange across the pulmonary capillary wall) lowered DM by 7.1% ( P &lt; 0.01) and was neutral in controls. At 1 wk, 83 patients that showed DM improvement &gt;5% were assigned to group 1, and 28 patients with DM worsening &gt;5% were assigned to group 2. Saline retained efficacy in group 2 and had no DM effect in group 1 (supporting a link between changes in baseline DM and those in microvascular salt exchange). Ventricular function was unchanged in group 1, whereas group 2 had developed diastolic dysfunction. At 1 yr, 3% of cases in group 1 and 37% of cases in group 2 had alveolar edema. Thus, AMI is frequently associated with abnormal pulmonary microvascular sodium transport\/water conductance that, in the case of ventricular dysfunction supervenience, may persist and worsen the outcome. In 37 AMI similar patients and 11 control subjects, nitric oxide overexpression with l-arginine improved baseline DM and in AMI patients prevented DM reduction by saline, suggesting a mechanistic role of an impaired nitric oxide pathway in the microvascular barrier dysfunction. <\/jats:p>","DOI":"10.1152\/ajpheart.00866.2007","type":"journal-article","created":{"date-parts":[[2008,1,12]],"date-time":"2008-01-12T01:55:02Z","timestamp":1200102902000},"page":"H1357-H1364","source":"Crossref","is-referenced-by-count":17,"title":["Evolving changes in lung interstitial fluid content after acute myocardial infarction: mechanisms and pathophysiological correlates"],"prefix":"10.1152","volume":"294","author":[{"given":"Marco","family":"Guazzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Arena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio D.","family":"Guazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000164273.57823.26"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.6.9804076"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.601005"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000151097.30779.04"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.5.2041"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Cooper CJ, Landzberg MJ, Anderson TJ, Charbonneau F, Creager MA, Ganz P, Selwin AP. 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