Document Detail


Exercise testing to estimate survival in pulmonary hypertension.
MedLine Citation:
PMID:  18799981     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND:: The 6-min walk distance (6MWD) predicts survival in pulmonary hypertension (PH). The peak oxygen consumption (V O2peak) measured during a cardiopulmonary exercise test (CPET) also relates to survival in PH, and it is unknown how the prognostic information from measurements of ventilatory responses and gas exchange during CPET compares to the prognostic information obtained by the 6MWD alone. The aims of our study were to compare prognostic values of different exercise parameters in PH and to assess whether CPET adds prognostic value to the information from the 6MWD. METHODS:: After baseline right-heart catheterization and exercise testing, survival was assessed in a cohort of 115 PH patients. RESULTS:: During the 4 yr of follow-up, 18 patients died. At baseline, pulmonary arterial pressure was 49 +/- 17 mm Hg, the slope relating minute ventilation to carbon dioxide output (V E/V CO2slope) = 45 +/- 11, V O2peak = 15 +/- 6 mL.kg.min, increase in O2 pulse from rest to peak exercise (DeltaO2 pulse) = 5 +/- 2 mL.beat, and 6MWD = 445 +/- 128 m. For the prediction of mortality, the areas under the receiver operating curves were very similar for the different parameters and ranged from 0.69 to 0.74. Patients with a V E/V CO2slope < 48, V O2peak > 13.2 mL.kg.min, DeltaO2 pulse > 3.3 mL.beat, or a 6MWD > 399 m had a higher cumulative survival (P < 0.05). Multivariable Cox regression with a forward selection procedure showed that only DeltaO2 pulse improved the univariate 6MWD prediction model significantly (P < 0.05). CONCLUSION:: CPET parameters predict survival in PH patients and add marginally to the prognostic value of the 6MWD.
Authors:
Herman Groepenhoff; Anton Vonk-Noordegraaf; Anco Boonstra; Marieke D Spreeuwenberg; Pieter E Postmus; Harm J Bogaard
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  40     ISSN:  1530-0315     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-18     Completed Date:  2008-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1725-32     Citation Subset:  IM; S    
Affiliation:
Institute for Cardiovascular Research and Department of Pulmonology, VU University Medical Center, Amsterdam, The Netherlands. h.groepenhoff@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Exercise Test*
Female
Humans
Hypertension, Pulmonary / mortality*,  physiopathology*
Male
Middle Aged
Oxygen Consumption
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Respiratory Function Tests
Retrospective Studies
Survival Analysis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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