| Assessment of pulmonary arterial pressure during exercise in collagen vascular disease: echocardiography vs right-sided heart catheterization. | |
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MedLine Citation:
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PMID: 20418368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: This study compared the results of exercise Doppler echocardiography (EDE) with right-sided heart catheterization (RHC) and evaluated the combination of EDE and cardiopulmonary exercise testing (CPET) as a screening method for early pulmonary vasculopathy in patients with connective tissue disease. METHODS: Patients (N = 52) with connective tissue disease (predominantly systemic sclerosis) and without known pulmonary arterial hypertension underwent both EDE and CPET. If systolic pulmonary arterial pressure (SPAP) was > 40 mm Hg during exercise or peak oxygen uptake (Vo(2)) was < 75% predicted, RHC was suggested. RESULTS: EDE showed an SPAP > 40 mm Hg during exercise in 26/52 patients. Additionally, CPET showed a peak Vo(2) < 75% predicted in 10/26 patients with SPAP <or= 40 mm Hg upon exercise. Accordingly, RHC was suggested to 36 patients. RHC was performed in 28 of these patients, revealing SPAP > 40 mm Hg in 25 patients (n = 1 at rest, n = 24 during exercise). SPAP values assessed by EDE showed no significant difference vs RHC at rest, 25 W, 50 W, and maximal exercise (difference [95% CI]: 0.3 [-2.7; 3.2], -1.3 [-7.1; 4.4], 0.9 [-7.7; 5.9], and -5.6 [-13.5; 2.2] mm Hg). Eight patients with exercise SPAP > 40 mm Hg had an exercise pulmonary arterial wedge pressure > 20 mm Hg, suggesting exercise-induced left ventricular diastolic dysfunction not detectable by EDE. CONCLUSIONS: EDE appears to be a reasonable noninvasive method to detect SPAP increase during exercise in connective tissue disease. In combination with CPET, it may be a useful screening tool for early pulmonary vasculopathy, although RHC remains the gold standard for hemodynamic assessment. Trial registration: clinicaltrials.gov; Identifier: NCT00609349 (Early Recognition of Pulmonary Arterial Hypertension). |
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Authors:
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Gabor Kovacs; Robert Maier; Elisabeth Aberer; Marianne Brodmann; Stefan Scheidl; Christian Hesse; Natascha Troester; Wolfgang Salmhofer; Rudolf Stauber; Florentine C Fuerst; Rene Thonhofer; Petra Ofner-Kopeinig; Ekkehard Gruenig; Horst Olschewski |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-23 |
Journal Detail:
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Title: Chest Volume: 138 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-04 Completed Date: 2010-08-19 Revised Date: 2010-12-22 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 270-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Pulmonology, Medical University of Graz, 8036 Graz, Auenbruggerplatz 20, Austria. gabor.kovacs@klinikum-graz.at |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00609349 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure Connective Tissue Diseases / complications* Echocardiography, Doppler* Exercise Test Female Heart Catheterization* Humans Hypertension, Pulmonary / diagnosis*, etiology Male Mass Screening Middle Aged Pulmonary Artery / physiopathology* |
| Comments/Corrections | |
Comment In:
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Chest. 2010 Dec;138(6):1523-4; author reply 1524
[PMID:
21138893
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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