Ventilatory power, a cardiopulmonary exercise testing parameter for the prediction of pulmonary hypertension at right heart catheterization.
6MWT, 6-minute walking test
BMI, body mass index
CI, cardiac index
COPD, chronic obstructive pulmonary disease
CPET, cardiopulmonary exercise testing
Cardiopulmonary exercise test
Cpc-PH, combined post-capillary and pre-capillary pulmonary hypertension
DPG, diastolic pressure gradient (diastolic PAP – mean PAWP)
Diastolic pressure gradient
ECG, electrocardiogram
EF, ejection fraction
Ipc-PH, isolated post-capillary pulmonary hypertension
NYHA, New York Heart Association
PAH, pulmonary arterial hypertension
PAWP, pulmonary artery wedge pressure
PAsP, systolic pulmonary arterial pressure
PH, pulmonary hypertension
PVR, pulmonary vascular resistance
Peak VO2, peak oxygen consumption
PetCO2, end-tidal carbon dioxide tension
Pulmonary vascular resistance
RAP, right atrial pressure
RHC, right heart catheterization
RV, right ventricle
TPG, transpulmonary pressure gradient (mean PAP – mean PAWP)
Transpulmonary pressure gradient
VE, ventilation
VE/VCO2, minute ventilation- carbondioxide production ratio
VP, ventilatory power
Ventilatory power
mPAP, mean pulmonary arterial pressure
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
12
03
2020
revised:
01
04
2020
accepted:
03
04
2020
entrez:
30
4
2020
pubmed:
30
4
2020
medline:
30
4
2020
Statut:
epublish
Résumé
Several cardiopulmonary exercise test (CPET) parameters (peak VO To ascertain possible correlations between VP derived at CPET and hemodynamic parameters at right heart catheterization (RHC) indicative of PH. Forty-seven consecutive outpatients with suspect of PAH were assessed by CPET and RHC; VP was defined as peak SBP divided by the minute ventilation-CO2 production slope at CPET and Diastolic Pressure Gradient (DPG), Trans-pulmonary Pressure Gradient (TPG), mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) at RHC were also assessed and compared with VP. VP values were inversely related to mPAP (r -0.427, p 0.003), DPG (r -0.36, p 0.019), TPG (r: -0.43, p 0.004), and PVR (r -0.52, p 0.001). Correlations remained significant even after correction at multivariate analysis for age and gender. VP values below median identified subjects with mPAP ≥ 25 mmHg with an odds ratio of 4.5 (95% confidence interval 1.05-19.36, p < 0.05), an accuracy of 0.712 at ROC curve analysis (95% confidence interval 0.534-0.852, p < 0.05) and a positive predictive power 82%. In patients with suspected PAH, VP assessed at CPET might provide further information in predicting PAH at RHC. Correlations with PVR and DPG may be helpful in differentiating patients with isolated post-capillary PH from those with combined post-capillary and pre-capillary.
Sections du résumé
BACKGROUND
BACKGROUND
Several cardiopulmonary exercise test (CPET) parameters (peak VO
AIM
OBJECTIVE
To ascertain possible correlations between VP derived at CPET and hemodynamic parameters at right heart catheterization (RHC) indicative of PH.
METHODS
METHODS
Forty-seven consecutive outpatients with suspect of PAH were assessed by CPET and RHC; VP was defined as peak SBP divided by the minute ventilation-CO2 production slope at CPET and Diastolic Pressure Gradient (DPG), Trans-pulmonary Pressure Gradient (TPG), mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) at RHC were also assessed and compared with VP.
RESULTS
RESULTS
VP values were inversely related to mPAP (r -0.427, p 0.003), DPG (r -0.36, p 0.019), TPG (r: -0.43, p 0.004), and PVR (r -0.52, p 0.001). Correlations remained significant even after correction at multivariate analysis for age and gender. VP values below median identified subjects with mPAP ≥ 25 mmHg with an odds ratio of 4.5 (95% confidence interval 1.05-19.36, p < 0.05), an accuracy of 0.712 at ROC curve analysis (95% confidence interval 0.534-0.852, p < 0.05) and a positive predictive power 82%.
CONCLUSIONS
CONCLUSIONS
In patients with suspected PAH, VP assessed at CPET might provide further information in predicting PAH at RHC. Correlations with PVR and DPG may be helpful in differentiating patients with isolated post-capillary PH from those with combined post-capillary and pre-capillary.
Identifiants
pubmed: 32346602
doi: 10.1016/j.ijcha.2020.100513
pii: S2352-9067(20)30088-9
pii: 100513
pmc: PMC7178492
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100513Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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