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In patients with acute heart failure, lung water content is increased leading to pulmonary oedema.1 This can be detected clinically and radiologically, and makes a major contribution to the severe dyspnoea characteristic of this condition. In contrast, the lung water content in stable chronic cardiac failure has not been defined, as previous studies all included patients with overt fluid overload in their analysis.2–4 We therefore carried out a pilot study with computed tomography (CT) measurement of lung water in patients with stable chronic cardiac failure, as well as some patients with acute heart failure, and compared their scans with scans from patients without evidence of heart failure.
Seventeen patients with chronic cardiac failure (three women) took part in this study. The mean age was 60.4 years (range 41–79 years), mean height 1.73 m (1.58–1.97 m), and mean weight 83.3 kg (64–103 kg). Three were current smokers and four had never smoked. The cause of the heart failure was ischaemic heart disease (10 patients) or dilated cardiomyopathy (seven). All had at least one previous episode of pulmonary oedema and a mean left ventricular ejection fraction of 27% (range 15–40%) measured by echocardiography in nine and by gated blood pool scanning in eight. At the time of the study the patients had been stable …