Characteristics of cardiopulmonary exercise testing of patients with borderline mean pulmonary artery pressure.

Abstract

BACKGROUND:

Pulmonary hypertension patients with mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg had impaired cardiopulmonary exercise testing (CPET). Borderline mean pulmonary pressures (boPAP; 21-24 mm Hg) represent early pulmonary vasculopathy. The CPET characteristics of boPAP are a matter of discussion. We aimed to determine the CPET profile of such borderline hemodynamics.

METHODS:

A matched case-control study was conducted on consecutive boPAP patients at the Shanghai Pulmonary Hospital between Jan 2012 and Jan 2017. Hemodynamics, echocardiography, the pulmonary function test (PFT) and CPET parameters were compared between boPAP patients and normal mPAP patients which were matched 1:1 by sex and age. Conditional logistic regression analysis was performed to determine the efficacy of CPET in detecting boPAP.

RESULTS:

A total of 48 patients underwent RHC and CPET (24 Normal, 24 boPAP). There were no differences in the demographics, echocardiography and PFT. BoPAP patients had significantly decreased VO2 at the anaerobic threshold and peak VO2 /kg (858.4 ± 246.5 mL/min vs 727.9 ± 228.0 mL/min, P = 0.037; 21.1 ± 6.4 mL/min/kg vs. 15.5 ± 5.6 mL/min/kg, P = 0.001, respectively). Significant differences were not observed in ventilation efficiency. A trend of impaired oxygen pulse and submaximal exercise tolerance were observed in boPAP patients. Conditional logistical regression analysis revealed the risk of boPAP increased by 2.493 (95% confident interval: 1.388 to 4.476, P = 0.002) with every 5 mL/min/kg decrease in peak VO2 /kg.

CONCLUSIONS:

Patients with boPAP have a greater prevalence of exercise intolerance, a trend of impaired oxygen pulse and submaximal exercise tolerance.

• Authors: Rong Jiang, Hui Liu, Bigyan Pudasaini, Rui Zhang, Jian-Lin Xu, Lan Wang, Qin-Hua Zhao, Ping Yuan, Jian Guo, Jing He, Su-Gang Gong, Cheng Wu, Wen-Hui Wu, Ci-Jun Luo, Hong-Ling Qiu, Zhi-Cheng Jing, Jin-Ming Liu
• Journal: The clinical respiratory journal (Clin Respir J) Vol. 13 Issue 3 Pg. 148-158 (Mar 2019) ISSN: 1752-699X [Electronic] England
• PMID: 30667180 (Publication Type: Journal Article)
• Copyright: © 2019 John Wiley & Sons Ltd.

Topics

• Adult
• Aged
• Case-Control Studies
• China
• Echocardiography
• Exercise Test (methods)
• Female
• Hemodynamics
• Humans
• Hypertension, Pulmonary (diagnosis, physiopathology)
• Logistic Models
• Male
• Middle Aged
• Pulmonary Artery (physiopathology)
• Respiratory Function Tests