nach oben

Lung

Erschienen in:

11.03.2021 | STATE OF THE ART REVIEW

Diffuse Alveolar Hemorrhage in Cardiac Diseases

verfasst von: Biplab K. Saha, Woon H. Chong

Erschienen in: Lung | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Diffuse alveolar hemorrhage (DAH) is a rare condition with reported mortality ranging between 20 and 100%. There are many etiologies of DAH. Cardiac diseases are likely underreported causes of DAH. Heart failure and mitral valve diseases are the most common cardiac causes of DAH. The DAH results from pulmonary venous hypertension leading to stress failure of the pulmonary capillaries. There is also a contribution of the bronchial circulation. The Alveolar-capillary membrane or blood-gas barrier is an extremely thin structure that allows rapid and passive diffusion of oxygen from the inhaled air to the pulmonary capillaries while preventing pulmonary edema and DAH with chronic elevation of the transmural hydrostatic pressure. The purpose of this manuscript is to inform the clinician about this rare cause of DAH, which may be overlooked unless specifically sought after. We also discuss the pathophysiologic aspects of DAH and the safety mechanisms in place to prevent such occurrences.

Saha BK (2020) Idiopathic pulmonary hemosiderosis: A state of the art review. Respir Med 17(176):106234

Saha BK, Milman NT (2020) Idiopathic pulmonary hemosiderosis: a review of the treatments used during the past 30 years and future directions. Clin Rheumatol. https://doi.org/10.1007/s10067-020-05507-4CrossRefPubMedPubMedCentral

Green RJ, Ruoss SJ, Kraft SA, Duncan SR, Berry GJ, Raffin TA (1996) Pulmonary capillaritis and alveolar hemorrhage. Update on diagnosis and management Chest 110(5):1305–1316PubMed

Lara AR, Schwarz MI (2010) Diffuse Alveolar Hemorrhage. Chest 137(5):1164–1171PubMed

Jones RB, Cohen Tervaert JW, Hauser T, Luqmani R, Morgan MD, Peh CA et al (2010) Rituximab versus Cyclophosphamide in ANCA-Associated Renal Vasculitis. N Engl J Med 363(3):211–220PubMed

Saha BK (2021) Is it time to call idiopathic pulmonary hemosiderosis by the correct name? Immune-mediated pulmonary hemosiderosis. Am J Med Sci. https://doi.org/10.1016/j.amjms.2021.01.006CrossRefPubMed

Gallagher H, Kwan JTC, Jayne DRW (2002) Pulmonary renal syndrome: a 4-year, single-center experience. Am J Kidney Dis 39(1):42–47PubMed

Zamora MR, Warner ML, Tuder R, Schwarz MI (1997) Diffuse Alveolar Hemorrhage and Systemic Lupus Erythematosus: Clinical Presentation, Histology, Survival, and Outcome. Medicine 76(3):192–202PubMed

Benoit FL, Rulon DB, Theil GB, Doolan PD, Watten RH (1964) Goodpasture’s syndrome: a clinicopathologic entity. Am J Med 37:424–444PubMed

10.

Buja LM, Freed TA, Berman MA, Morrow AG, Roberts WC (1971) Pulmonary alveolar hemorrhage. A common finding in patients with severe cardiac disease. Am J Cardiol. 27(2):168–172PubMed

11.

Pappas L, Filippatos G (2011) Pulmonary Congestion in Acute Heart Failure: From Hemodynamics to Lung Injury and Barrier Dysfunction. Rev Esp Cardiol 64(9):735–738PubMed

12.

West JB, Tsukimoto K, Mathieu-Costello O, Prediletto R (1991) Stress failure in pulmonary capillaries. J Appl Physiol 70(4):1731–1742PubMed

13.

Starling EH (1896) On the Absorption of Fluids from the Connective Tissue Spaces. J Physiol 19(4):312–326PubMedPubMedCentral

14.

Sprung CL, Rackow EC, Fein IA, Jacob AI, Isikoff SK (1981) The spectrum of pulmonary edema: differentiation of cardiogenic, intermediate, and noncardiogenic forms of pulmonary edema. Am Rev Respir Dis 124(6):718–722PubMed

15.

Fein A, Grossman RF, Jones JG, Overland E, Pitts L, Murray JF et al (1979) The value of edema fluid protein measurement in patients with pulmonary edema. Am J Med 67(1):32–38PubMed

16.

West JB, Mathieu-Costello O (1995) Vulnerability of Pulmonary Capillaries in Heart Disease. Circulation 92(3):622–631PubMed

17.

Pietra GG, Szidon JP, Leventhal MM, Fishman AP (1969) Hemoglobin as a Tracer in Hemodynamic Pulmonary Edema. Science 166(3913):1643–1646PubMed

18.

Ceridon M, Wanner A, Johnson BD (2009) Does the Bronchial Circulation Contribute to Congestion in Heart Failure? Med Hypotheses 73(3):414–419PubMedPubMedCentral

19.

Low FN (1953) The pulmonary alveolar epithelium of laboratory mammals and man. Anat Rec 117(2):241–263PubMed

20.

Gehr P, Bachofen M, Weibel ER (1978) The normal human lung: ultrastructure and morphometric estimation of diffusion capacity. Respir Physiol 32(2):121–140PubMed

21.

Dempsey JA, Hanson PG, Henderson KS (1984) Exercise-induced arterial hypoxaemia in healthy human subjects at sea level. J Physiol 355:161–175PubMedPubMedCentral

22.

Wagner PD, Gale GE, Moon RE, Torre-Bueno JR, Stolp BW, Saltzman HA (1986) Pulmonary gas exchange in humans exercising at sea level and simulated altitude. J Appl Physiol 61(1):260–270PubMed

23.

Bhattacharya J, Nanjo S, Staub NC (1982) Micropuncture measurement of lung microvascular pressure during 5-HT infusion. J Appl Physiol 52(3):634–637PubMed

24.

Younes M, Bshouty Z, Ali J (1987) Longitudinal distribution of pulmonary vascular resistance with very high pulmonary blood flow. J Appl Physiol 62(1):344–358PubMed

25.

Groves BM, Reeves JT, Sutton JR, Wagner PD, Cymerman A, Malconian MK et al (1987) Operation Everest II: elevated high-altitude pulmonary resistance unresponsive to oxygen. J Appl Physiol 63(2):521–530PubMed

26.

Reeves JT, Groves BM, Cymerman A, Sutton JR, Wagner PD, Turkevich D et al (1990) Operation Everest II: Cardiac filling pressures during cycle exercise at sea level. Respir Physiol 80(2):147–154PubMed

27.

West JB, Mathieu-Costello O (1992) Strength of the pulmonary blood-gas barrier. Respir Physiol 88(1):141–148PubMed

28.

Gil J, Bachofen H, Gehr P, Weibel ER (1979) Alveolar volume-surface area relation in air- and saline-filled lungs fixed by vascular perfusion. J Appl Physiol Respir Environ Exerc Physiol 47(5):990–1001PubMed

29.

Azar D, Ohadi D, Rachev A, Eberth JF, Uline MJ, Shazly T (2018) Mechanical and geometrical determinants of wall stress in abdominal aortic aneurysms: A computational study. PLoS ONE 13(2):e0192032PubMedPubMedCentral

30.

Haupt MT (2003) Cardiogenic pulmonary edema: an inflammatory disorder? Crit Care Med 31(4):1282–1283PubMed

31.

Cohen AB, Stevens MD, Miller EJ, Atkinson MA, Mullenbach G, Maunder RJ et al (1993) Neutrophil-activating peptide-2 in patients with pulmonary edema from congestive heart failure or ARDS. Am J Physiol 264(5 Pt 1):L490-495PubMed

32.

Nakos G, Pneumatikos J, Tsangaris I, Tellis C, Lekka M (1997) Proteins and phospholipids in BAL from patients with hydrostatic pulmonary edema. Am J Respir Crit Care Med 155(3):945–951PubMed

33.

Birukov KG (2009) Cyclic stretch, reactive oxygen species, and vascular remodeling. Antioxid Redox Signal 11(7):1651–1667PubMedPubMedCentral

34.

Welling LW, Grantham JJ (1972) Physical properties of isolated perfused renal tubules and tubular basement membranes. J Clin Invest 51(5):1063–1075PubMedPubMedCentral

35.

Divertie MB, Brown AL (1964) The Fine Structure of the Normal Human Alveolocapillary Membrane. JAMA. https://doi.org/10.1001/jama.1964.03060250056012CrossRefPubMed

36.

Fisher RF, Wakely J (1976) The elastic constants and ultrastructural organization of a basement membrane (lens capsule). Proc R Soc Lond B Biol Sci 193(1113):335–358PubMed

37.

Haworth SG, Hall SM, Panja M, Patel M (1988) Peripheral pulmonary vascular and airway abnormalities in adolescents with rheumatic mitral stenosis. Int J Cardiol 18(3):405–416PubMed

38.

Lee YS (1979) Electron microscopic studies on the alveolar-capillary barrier in the patients of chronic pulmonary edema. Jpn Circ J 43(10):945–954PubMed

39.

Meyrick B, Reid L (1980) Hypoxia-induced structural changes in the media and adventitia of the rat hilar pulmonary artery and their regression. Am J Pathol 100(1):151–178PubMedPubMedCentral

40.

Berry JL (1935) The Relation Between Bronchial and Pulmonary Circulations in the Human Lung, Investigated by Radiopaque Injections. Q J Exp Physiol 24(4):305–314

41.

Woolley K, Stark P (1999) Pulmonary Parenchymal Manifestations of Mitral Valve Disease. Radiographics 19(4):965–972PubMed

42.

Menendez C, Martinez-Caro L, Moreno L, Nin N, Moral-Sanz J, Morales D et al (2013) Pulmonary vascular dysfunction induced by high tidal volume mechanical ventilation. Crit Care Med 41(8):e149-155PubMed

43.

Fishbein GA, Fishbein MC (2011) Lung vasculitis and alveolar hemorrhage: pathology. Semin Respir Crit Care Med 32(3):254–263PubMed

44.

Tamai K, Tomii K, Nakagawa A, Otsuka K, Nagata K (2015) Diffuse alveolar hemorrhage with predominantly right-sided infiltration resulting from cardiac comorbidities. Intern Med 54(3):319–324PubMed

45.

Andrade C, Mendonça T, Farinha F, Correia J, Marinho A, Almeida I et al (2016) Alveolar hemorrhage in systemic lupus erythematosus: a cohort review. Lupus 25(1):75–80PubMed

46.

de Prost N, Parrot A, Cuquemelle E, Picard C, Antoine M, Fleury-Feith J et al (2012) Diffuse alveolar hemorrhage in immunocompetent patients: etiologies and prognosis revisited. Respir Med 106(7):1021–1032PubMed

47.

Diamond MA (1971) Life-Threatening Hemoptysis in Mitral Stenosis: Emergency Mitral Valve Replacement Resulting in Rapid, Sustained Cessation of Pulmonary Bleeding. JAMA 215(3):441PubMed

48.

Sutherland ME, Haji H, Borgan SM, Eimer KM, Reed RM, McCurdy MT (2019) Life-threatening hemoptysis following mitral valvuloplasty for rheumatic mitral stenosis. Respir Med Case Rep. https://doi.org/10.1016/j.rmcr.2019.100921CrossRefPubMedPubMedCentral

49.

Spence TH, Connors JC (2000) Diffuse alveolar hemorrhage syndrome due to “silent” mitral valve regurgitation. South Med J 93(1):65–67PubMed

50.

Chong WH, Saha BK, Austin A, Chopra A (2021) The Significance of Subpleural Sparing in CT Chest: A State-of-the-Art Review. Am J Med Sci. https://doi.org/10.1016/j.amjms.2021.01.008CrossRefPubMed

51.

Khorashadi L, Wu CC, Betancourt SL, Carter BW (2015) Idiopathic pulmonary haemosiderosis: spectrum of thoracic imaging findings in the adult patient. Clin Radiol 70(5):459–465PubMed

52.

Jonckheer J, Slabbynck H, Spapen H (2017) Diffuse alveolar haemorrhage with predominant upper lung lobe involvement associated with congestive heart failure: a case series. J Thorac Dis 9(10):3956–3960PubMedPubMedCentral

53.

Steiner RE, Goodwin JF (1954) Some observations on mitral valve disease. Journal of the Faculty of Radiologists 5(3):167–177

54.

Galloway RW, Epstein EJ, Coulshed N (1961) Pulmonary ossific nodules in mitral valve disease. Br Heart J 23(3):297–307PubMedPubMedCentral

55.

de Prost N, Parrot A, Picard C, Ancel P-Y, Mayaud C, Fartoukh M et al (2010) Diffuse alveolar haemorrhage: factors associated with in-hospital and long-term mortality. Eur Respir J 35(6):1303–1311PubMed

56.

Kumar RK, Tandon R (2013) Rheumatic fever & rheumatic heart disease: The last 50 years. Indian J Med Res 137(4):643–658PubMedPubMedCentral

57.

Nennhaus HP, Hunter JA (1967) Massive hemorrhage from bronchial varices in mitral stenosis. Surgery 61(4):556–560PubMed

58.

Patton R, Martinez V, Buchness M (1969) Fatal Hemoptysis in Mitral Stenosis. Dis Chest 56(1):77–80PubMed

59.

Schwartz R, Myerson RM, Lawrence LT, Nichols HT (1966) Mitral Stenosis, Massive Pulmonary Hemorrhage, and Emergency Valve Replacement. N Engl J Med 275(14):755–758PubMed

60.

Oppenheimer BS, Schwartz SP (1933) Paroxysmal pulmonary hemorrhages: The syndrome in young adults with mitral stenosis. Am Heart J 9(1):14–25

61.

Leung W-H, Lau C-P, Wong C-K, Cheng C-H (1990) Fatal massive pulmonary hemorrhage complicating mitral stenosis. Clin Cardiol 13(2):136–138PubMed

62.

Chokshi K, Arancibia R, Mahoney J, Krishnan P (2016) Unusual Presentation of Diffuse Alveolar Hemorrhage (DAH) in Chronic Mitral Regurgitation. Chest 149(4):A473

63.

Marak CP, Joy PS, Gupta P, Bukovskaya Y, Guddati AK (2013) Diffuse Alveolar Hemorrhage due to Acute Mitral Valve Regurgitation. Case Reports in Pulmonology. https://doi.org/10.1155/2013/179587CrossRefPubMedPubMedCentral

64.

Alarcón JJ, Guembe P, De Miguel E, Gordillo I, Abellás A (1995) Localized Right Upper Lobe Edema. Chest 107(1):274–276PubMed

65.

Schnyder PA, Sarraj AM, Duvoisin BE, Kapenberger L, Landry MJ (1993) Pulmonary edema associated with mitral regurgitation: prevalence of predominant involvement of the right upper lobe. Am J Roentgenol 161(1):33–36

66.

Hales CA, Mark EJ (1995) Case 17–1995. An 81-year-old woman with mitral regurgitation and a left-upper-lobe pulmonary infiltrate. N Engl J Med 332(23):1566–1572

67.

Attias D, Mansencal N, Auvert B, Vieillard-Baron A, Delos A, Lacombe P et al (2010) Prevalence, characteristics, and outcomes of patients presenting with cardiogenic unilateral pulmonary edema. Circulation 122(11):1109–1115PubMed

68.

Akiyama K, Suetsugu F, Hidai T, Shimamoto K, Takahashi S (1994) Left-sided unilateral pulmonary edema in postinfarction ventricular septal rupture. Chest 105(4):1264–1265PubMed

69.

Marom EM, Herndon JE, Kim YH, McAdams HP (2004) Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation. Radiology 230(3):824–829PubMed

70.

Shin JH, Kim SH, Park J, Lim Y-H, Park H-C, Choi SI et al (2012) Unilateral Pulmonary Edema: A Rare Initial Presentation of Cardiogenic Shock due to Acute Myocardial Infarction. J Korean Med Sci 27(2):211–214PubMedPubMedCentral

71.

Denst J, Edwards A, Neubuerger KT, Blount SG (1954) Biopsies of the lung and atrial appendages in mitral stenosis; correlation of data from cardiac catheterization with pulmonary vascular lesions. Am Heart J 48(4):506–520PubMed

72.

Wood P (1954) An appreciation of mitral stenosis I. Br Med J 1(4870):1051–1063PubMedPubMedCentral

73.

Dernellis JM, Stefanadis CI, Zacharoulis AA, Toutouzas PK (1998) Left atrial mechanical adaptation to long-standing hemodynamic loads based on pressure-volume relations. Am J Cardiol 81(9):1138–1143PubMed

74.

Phan TT, Abozguia K, Shivu GN, Ahmed I, Leyva F, Patel K et al (2009) Increased atrial contribution to left ventricular filling compensates for impaired early filling during exercise in heart failure with preserved ejection fraction. J Card Fail 15(10):890–897PubMed

75.

Kihara Y, Sasayama S, Miyazaki S, Onodera T, Susawa T, Nakamura Y et al (1988) Role of the left atrium in adaptation of the heart to chronic mitral regurgitation in conscious dogs. Circ Res 62(3):543–553PubMed

76.

Melenovsky V, Hwang S-J, Redfield MM, Zakeri R, Lin G, Borlaug BA (2015) Left Atrial Remodeling and Function in Advanced Heart Failure With Preserved or Reduced Ejection Fraction. Circ Heart Fail 8(2):295–303

Titel: Diffuse Alveolar Hemorrhage in Cardiac Diseases
verfasst von: Biplab K. Saha
Woon H. Chong
Publikationsdatum: 11.03.2021
Verlag: Springer US
Erschienen in: Lung / Ausgabe 2/2021
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-021-00433-x

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

25.04.2024 | Hypotonie | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Diffuse Alveolar Hemorrhage in Cardiac Diseases

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Viel Bewegung in der Parkinsonforschung

Adjuvante Immuntherapie verlängert Leben bei RCC

Update Innere Medizin

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2021

Comparison of Multiple Diagnostic Tests to Measure Dynamic Hyperinflation in Patients with Severe Emphysema Treated with Endobronchial Coils

Computed Tomography Findings as Determinants of Local and Systemic Inflammation Biomarkers in Interstitial Lung Diseases: A Retrospective Registry-Based Descriptive Study

Tofacitinib as a Steroid-Sparing Therapy in Pulmonary Sarcoidosis, an Open-Label Prospective Proof-of-Concept Study

Lessons from Pharmacovigilance: Pulmonary Immune-Related Adverse Events After Immune Checkpoint Inhibitor Therapy

Corticosteroid-Sparing Drugs in Sarcoidosis: How Should We Assess Them?

Modified Reflux Scintigraphy Detects Pulmonary Microaspiration in Severe Gastro-Esophageal and Laryngopharyngeal Reflux Disease

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Viel Bewegung in der Parkinsonforschung

Adjuvante Immuntherapie verlängert Leben bei RCC

Update Innere Medizin