Document Detail

Detection of Exercise-Induced Pulmonary Arterial Hypertension by Cardiopulmonary Exercise Testing.
MedLine Citation:
PMID:  22588968     Owner:  NLM     Status:  Publisher    
BACKGROUND: The pulmonary arterial pressure (PAP) response to exercise may provide a tool for the early detection of pulmonary arterial hypertension (PAH). Therefore, an accurate noninvasive method for evaluating exercise-induced PAH (EIPAH) is desirable. HYPOTHESIS: We sought to examine if cardiopulmonary exercise testing (CPET) is able to indicate EIPAH. METHODS: Fifty-three patients aged 67.1 ± 1.7 years (37 female, 16 male) with borderline PAH (resting mean PAP 21-24 mm Hg) performed CPET and right heart catheterization at rest and during handgrip testing. RESULTS: When comparing patients with an exercise-induced mean PAP ≥35 mm Hg (group A, n = 24) and subjects with an exercise-induced mean PAP <35 mm Hg (group B, n = 29), group A had a significantly lower mean aerobic capacity (15.2 ± 1.2 vs 19.7 ± 1.2 mL/min/kg; P = 0.02), higher ventilatory equivalents for oxygen at the anaerobic threshold (34.3 ± 1.5 vs 29.9 ± 1.1; P = 0.02), a widening of the mean alveolar-arterial oxygen difference (37.8 ± 3.0 vs 26.8 ± 2.4 mm Hg; P = 0.007), an elevated mean functional dead space ventilation (29.5 ± 2.7 vs 21.2 ± 1.7%; P = 0.008), and a higher mean arterial to end-tidal carbon dioxide gradient at peak exercise (3.7 ± 0.9 vs 0.4 ± 0.8 mm Hg; P = 0.007). CONCLUSIONS: EIPAH is characterized by a decreased ventilatory efficiency due to ventilation to perfusion inequalities. CPET may be useful for the identification of EIPAH and serve to diagnose PAH at an early stage. Drs. Schwaiblmair, von Scheidt, and Berghaus conceived and designed the study. Drs. Schwaiblmair, Faul, and Berghaus acquired the study data. Dr. Schwaiblmair performed the statistical analysis and drafted the article. All authors participated in interpreting the data and revised the manuscript for important intellectual content. The authors have no funding, financial relationships, or conflicts of interest to disclose.
Martin Schwaiblmair; Christian Faul; Wolfgang von Scheidt; Thomas M Berghaus
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-15
Journal Detail:
Title:  Clinical cardiology     Volume:  -     ISSN:  1932-8737     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Department of Internal Medicine I, Klinikum Augsburg, Ludwig-Maximilians-University, Munich, Germany.
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