The circulation in patients with chronic bronchitis and emphysema at rest and during exercise, with special reference to the influence of changes in blood viscosity and blood volume on the pulmonary circulation.

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Abstract
A highly selected and severely disabled group of patients with chronic bronchitis and marked polycythemia were studied by cardiac catheterization. Severe pulmonary hypertension, hypoxemia and hypercapnia were present at rest and on exercise the response of cardiac output was impaired. Serial studies showed these changes to be progressive over several years. After repeated venesection had restored hematocrit to normal there was on average only a small fall in pulmonary arterial pressure, but Individual changes correlated positively with changes in total blood volume. The findings suggest that the level of total and central blood volume contribute importantly to pulmonary hypertension in such patients while increased blood viscosity plays a minor part.