| Differences in Ventilatory Inefficiency Between Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension. | |
| | |
MedLine Citation:
|
PMID: 21527511 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
ABSTRACT BACKGROUND: Measures of ventilatory efficiency during cardiopulmonary exercise testing (CPX) are increasingly being used as prognostic markers in heart failure and pulmonary hypertension (PH). Little is known about whether these measures can be applied to all forms of PH, in particular chronic thromboembolic pulmonary hypertension (CTEPH), where thrombotic vascular occlusion has an impact on gas exchange. METHODS AND RESULTS: 127 patients, 50 with CTEPH and 77 with pulmonary arterial hypertension (PAH), underwent incremental CPX. Physiological ventilatory deadspace fraction (V(D)/V(Tphys)) measured at peak exercise with arterial blood gas analysis was higher in CTEPH than PAH (52.9 vs 41.8, P<0.001). The V(E)/VCO(2) slope was higher in CTEPH patients than in PAH patients (50.7 vs. 44.4, p=0.024) and was mirrored by similar changes in the ventilatory equivalent for CO(2) at anerobic threshold (EqCO2_AT) (47.7 vs.42.0 p=0.008). In a multivariate linear regression analysis, disease subtype was found to be an independent predictor of V(D)/V(Tphys) (p<0.001), V(E)/VCO(2) slope (p=0.003) and EqCO2_AT (p<0.001). These three measures could distinguish between WHO functional classes I/II and III/IV in PAH, but not CTEPH. CONCLUSION: Significant differences in gas exchange exist between CTEPH and PAH, due to differences in V(D)/V(Tphys) likely as a result of vascular occlusion due to thromboembolic disease. This dissociates measures of ventilatory efficiency from disease severity and also contributes to our understanding of the differences in exercise limitation and breathlessness in PAH and CTEPH. Common prognostic end-points from CPX cannot be applied to all forms of PH. |
| | |
Authors:
|
Zhenguo Zhai; Kevin Murphy; Hannah Tighe; Chen Wang; Martin R Wilkins; J Simon R Gibbs; Luke S Howard |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-4-28 |
Journal Detail:
|
Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
|
Created Date: 2011-4-29 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1Imperial College School of Medicine, Imperial College London, London, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Validation of a Novel Risk Score for Severity of Illness in Acute Exacerbations of Chronic Obstructi...
Next Document: Collective Efficacy and Major Depression in Urban Neighborhoods.