Bronchial hyperresponsiveness and exhaled nitric oxide in patients with cardiac disease

Background: Increased concentrations of exhaled nitric oxide (NO) correlate with increased airway inflammation and measurement of exhaled NO is a noni nvasive method for the management of bronchial asthma. in various cardiac d iseases, bronchial hyperresponsiveness is observed, as is bronchial asthma. However, there have been few studies on the relationship between exhaled N O and bronchial responsiveness in cardiac diseases. Objective: The aim of t his study was to clarify the association between exhaled NO and bronchial h yperresponsiveness in patients with cardiac disease, Methods: We measured e xpired NO and bronchial responsiveness to inhaled methacholine in 19 patien ts with cardiac diseases and 17 with bronchial asthma. We divided the cardi ac disease patients into two groups according to their bronchial responsive ness to inhaled methacholine: BHR(+) group consisted of 12 patients with br onchial hyperresponsiveness and BHR(-) group consisted of 7 patients withou t bronchial hyperresponsiveness. Resuits: The concentration of exhaled NO i n the asthmatic patients was significantly higher than that in the BHR(+) a nd BHR(-) groups (142.0 +/- 17.0, 33.6 +/- 6.4 and 42.3 +/- 10.3 ppb, respe ctively, p < 0.01). There was no significant difference in exhaled NO betwe en BHR(+) and BHR(-) groups. There were also no significant differences in the parameters of bronchial hyperresponsiveness between the cardiac BHR(+) and bronchial asthma groups. These results indicate that bronchial hyperres ponsiveness in patients with cardiac diseases is not a consequence of eosin ophilic inflammation or of exhaled NO. Conclusion: We conclude that bronchi al hyperresponsiveness in patients with cardiac diseases can occur independ ently of NO production. Copyright(C)2001 S. Karger AG,Basel.