{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T08:05:12Z","timestamp":1772179512924,"version":"3.50.1"},"reference-count":0,"publisher":"American Physiological Society","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[1993,7,1]]},"abstract":"<jats:p> The majority of patients with intrapulmonary right-to-left shunting due to pulmonary arteriovenous malformations-exhibit good maximum exercise capacity (&gt; 70% predicted) despite profound arterial oxygen desaturation. We studied seven such patients to assess tissue oxygen delivery during steady-state exercise. From rest to exercise [50 +\/- 7 (SE) W] arterial saturation fell from 80 +\/- 3 to 74 +\/- 3%, and mean right-to-left shunt increased slightly from 31 +\/- 4 to 34 +\/- 5% (P = NS). Minute ventilation was high for oxygen uptake, and the ventilatory equivalent was raised (174 +\/- 19% predicted) and was correlated with shunt size (r = 0.93). The majority of the patients maintained pulmonary alveolar blood flow within the predicted range for their power output, but total cardiac output was increased to 142 +\/- 11% predicted due to flow through the shunt. Consequently, on exercise, oxygen delivery per unit oxygen consumption [2.3\u20133.3 (normal range 1.6\u20132.4)] and calculated mixed venous oxygen tension (27.0 +\/- 0.8 Torr) were preserved. Arterial PCO2 rose on exercise by 2.8 +\/- 1.2 Torr, in proportion to the ratio of flow through the shunt to total cardiac output (r = 0.73), but remained low (33.1 +\/- 1.4 Torr) in absolute terms. The high cardiac output on exercise may be facilitated by a low pulmonary vascular resistance (0.33 +\/- 0.08 mmHg.1\u20131.min, measured at rest), which may explain why exercise performance is better in these patients than in patients with equivalent hypoxemia from other causes. <\/jats:p>","DOI":"10.1152\/jappl.1993.75.1.321","type":"journal-article","created":{"date-parts":[[2017,12,22]],"date-time":"2017-12-22T00:40:48Z","timestamp":1513903248000},"page":"321-328","source":"Crossref","is-referenced-by-count":44,"title":["Cardiopulmonary response to exercise in patients with intrapulmonary vascular shunts"],"prefix":"10.1152","volume":"75","author":[{"given":"M. K.","family":"Whyte","sequence":"first","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. E.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. M.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. C.","family":"Hempleman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. P.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"24","container-title":["Journal of Applied Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.physiology.org\/doi\/pdf\/10.1152\/jappl.1993.75.1.321","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,8]],"date-time":"2019-09-08T16:34:20Z","timestamp":1567960460000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.physiology.org\/doi\/10.1152\/jappl.1993.75.1.321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,7,1]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1993,7,1]]}},"alternative-id":["10.1152\/jappl.1993.75.1.321"],"URL":"https:\/\/doi.org\/10.1152\/jappl.1993.75.1.321","relation":{},"ISSN":["8750-7587","1522-1601"],"issn-type":[{"value":"8750-7587","type":"print"},{"value":"1522-1601","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,7,1]]}}}