Bronchial Hyperresponsiveness to Methacholine in Patients with Impaired Left Ventricular Function

Abstract

To elucidate the pathogenesis of bronchospasm in congestive heart failure, we studied 23 patients with chronic impairment of left ventricular function due to coronary artery disease or dilated cardiomyopathy. In 21 of them we found marked bronchial hyperresponsiveness to methacholine. The mean dose (±SD) of methacholine that elicited a 20 percent decrease in the forced expiratory volume in one second (FEV₁) was 421±298-μg, nearly the same as in patients with symptomatic asthma. In contrast, there was no bronchial response to methacholine in 9 of 10 patients who had coronary artery disease but normal left ventricular function.