{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T03:53:20Z","timestamp":1774929200382,"version":"3.50.1"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[1989,2,1]],"date-time":"1989-02-01T00:00:00Z","timestamp":602294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1989,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We have recently shown that ventilation-perfusion ( \u00a0a\/) mismatching at rest in cirrhosis is due to an abnormal pulmonary vascular tone. It has been suggested that in patients with cirrhosis, O2 transfer might become diffusion-limited during exercise. This study examined pulmonary hemodynamics and mechanisms modulating gas exchange during exericise (60 to 70% \u00a0O2max) in six patients (41 \u00b1 5 yr, \u00b1 SEM) with cirrhosis but with normal lung function tests. At rest, \u00a0t was high (8.4 \u00b1 0.5 L\/min), pulmonary vascular resistance (PVR) was low (0.61 \u00b1 0.17 mm Hg\/L\/min), and there was mild to moderate \u00a0a\/ mismatching (Logsd Q, 0.79 \u00b1 0.09; normal range, 0.3 to 0.6). However, hyperventilation (PaCO2, 29 \u00b1 2 mm Hg) and high \u00a0t (thus, high P \u00a0O2, 41 \u00b1 2 mm Hg) contributed to the maintenance of PaO2 within normal values (99 \u00b1 7 mm Hg). Exercise \u00a0O2 (1,278 \u00b1 122 ml\/min) was normal relative to work load, but, contrary to that in normal subjects, \u00a0t was higher and PVR did not fall. During exercise, PaO2 showed a trend to decrease (to 90 \u00b1 5 mm Hg) and PaCO2 to rise (to 35 \u00b1 2 mm Hg), but the differences failed to reach statistical significance (p = 0.07 each). Pa \u00a0O2 fell significantly with exercise (41 \u00b1 2 to 33 \u00b1 0.3 mm Hg, p &amp;lt; 0.05), but neither AaPaO2 (15 \u00b1 7 to 21 \u00b1 6 mm Hg) nor \u00a0a\/ inequality (Logsd, 0.82 \u00b1 0.11) changed. No systematic difference was noticed between predicted and measured PaO2 values, suggesting no O2 diffusion impairment during exercise. We conclude that exercise in patients with liver cirrhosis (1) perpetuates the hyperdynamic cardiovascular state observed at rest, (2) cannot modify PVR because the pulmonary circulation is already maximally dilated at rest, and (3) does not change the efficiency of the lung as a gas exchanger. Specifically, no limitation for the O2 transfer ensues. We suggest that changes in PaO2 with exercise are fully explained by the interplay of the extrapulmonary factors, namely, \u00a0t, \u00a0e, and \u00a0O2.<\/jats:p>","DOI":"10.1164\/ajrccm\/139.2.485","type":"journal-article","created":{"date-parts":[[2011,7,22]],"date-time":"2011-07-22T00:53:42Z","timestamp":1311296022000},"page":"485-491","source":"Crossref","is-referenced-by-count":43,"title":["Pulmonary Hemodynamics and Gas Exchange during Exercise in Liver Cirrhosis"],"prefix":"10.1093","volume":"139","author":[{"given":"Alvar GN.","family":"Agusti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Roca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Rodriguez-Roisin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Mastai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D.","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1989,2,1]]},"reference":[{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60852-0"},{"key":"p_10","doi-asserted-by":"publisher","DOI":"10.1172\/JCI106899"},{"key":"p_16","first-page":"S5","year":"1971","journal-title":"Huber"},{"key":"p_21","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(77)90161-9"},{"key":"p_38","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(66)90593-X"},{"key":"p_42","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)62438-0"},{"key":"p_65","first-page":"352","volume":"131","year":"1985","journal-title":"Dis"},{"key":"p_69","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1152\/jappl.1986.61.1.260","volume":"61","year":"1986","journal-title":"J Appl Physiol"},{"key":"p_72","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1152\/jappl.1966.21.4.1375","volume":"21","year":"1966","journal-title":"J Appl Physiol"},{"key":"p_74","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1152\/jappl.1974.36.5.600","volume":"36","author":"Simultaneous","year":"1974","journal-title":"J Appl Physiol"},{"key":"p_77","first-page":"361","year":"1977","journal-title":"Iung. 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