Oxygen Pathway Limitations in Patients With Chronic Thromboembolic Pulmonary Hypertension.

Chronic Disease Female Healthy Volunteers Humans Hypertension, Pulmonary / physiopathology Male Middle Aged Oxygen / physiology
cardiac output exercise heart ventricles hypertension, pulmonary magnetic resonance imaging systems biology

Journal

Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763

Informations de publication

Date de publication:
25 05 2021
Historique:
pubmed: 16 4 2021
medline: 24 12 2021
entrez: 15 4 2021
Statut: ppublish

Résumé

Exertional intolerance is a limiting and often crippling symptom in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Traditionally the pathogenesis has been attributed to central factors, including ventilation/perfusion mismatch, increased pulmonary vascular resistance, and right heart dysfunction and uncoupling. Pulmonary endarterectomy and balloon pulmonary angioplasty provide substantial improvement of functional status and hemodynamics. However, despite normalization of pulmonary hemodynamics, exercise capacity often does not return to age-predicted levels. By systematically evaluating the oxygen pathway, we aimed to elucidate the causes of functional limitations in patients with CTEPH before and after pulmonary vascular intervention. Using exercise cardiac magnetic resonance imaging with simultaneous invasive hemodynamic monitoring, we sought to quantify the steps of the O Peak Vo We demonstrated that patients with CTEPH have significant impairment of all steps in the O

Sections du résumé

BACKGROUND
Exertional intolerance is a limiting and often crippling symptom in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Traditionally the pathogenesis has been attributed to central factors, including ventilation/perfusion mismatch, increased pulmonary vascular resistance, and right heart dysfunction and uncoupling. Pulmonary endarterectomy and balloon pulmonary angioplasty provide substantial improvement of functional status and hemodynamics. However, despite normalization of pulmonary hemodynamics, exercise capacity often does not return to age-predicted levels. By systematically evaluating the oxygen pathway, we aimed to elucidate the causes of functional limitations in patients with CTEPH before and after pulmonary vascular intervention.
METHODS
Using exercise cardiac magnetic resonance imaging with simultaneous invasive hemodynamic monitoring, we sought to quantify the steps of the O
RESULTS
Peak Vo
CONCLUSIONS
We demonstrated that patients with CTEPH have significant impairment of all steps in the O

Identifiants

DOI: 10.1161/CIRCULATIONAHA.120.052899 PMID: 33853383
pubmed: 33853383
doi: 10.1161/CIRCULATIONAHA.120.052899
doi:

Substances chimiques

Oxygen S88TT14065

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2061-2073

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Auteurs

Erin J Howden (EJ)

Baker Heart and Diabetes Institute (E.J.H., S.R.-C., A.L.G., G.C.), Melbourne, Australia.

Sergio Ruiz-Carmona (S)

Cambridge Baker Systems Genomics Initiative (S.R.-C.), Melbourne, Australia.
Baker Heart and Diabetes Institute (E.J.H., S.R.-C., A.L.G., G.C.), Melbourne, Australia.

Mathias Claeys (M)

Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Ruben De Bosscher (R)

Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Rik Willems (R)

Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Bart Meyns (B)

Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Tom Verbelen (T)

Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Geert Maleux (G)

Imaging & Pathology (G.M., J.B.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Laurent Godinas (L)

Chronic Diseases and Metabolism (L.G., C.B., M.D.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Catharina Belge (C)

Chronic Diseases and Metabolism (L.G., C.B., M.D.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Jan Bogaert (J)

Imaging & Pathology (G.M., J.B.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Piet Claus (P)

Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Andre La Gerche (A)

Baker Heart and Diabetes Institute (E.J.H., S.R.-C., A.L.G., G.C.), Melbourne, Australia.
Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.

Marion Delcroix (M)

Chronic Diseases and Metabolism (L.G., C.B., M.D.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

Guido Claessen (G)

Baker Heart and Diabetes Institute (E.J.H., S.R.-C., A.L.G., G.C.), Melbourne, Australia.
Departments of Cardiovascular Sciences (M.C., R.D.B., R.W., B.M., T.V., P.C., A.L.G., G.C.), KU Leuven, Belgium.
University Hospitals Leuven, Belgium (M.C., R.D.B., R.W., B.M., T.V., G.M., L.G., C.B., J.B., P.C., M.D., G.C.).

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Classifications MeSH

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questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Hypertension artérielle › Hypertension pulmonaire › Oxygen Pathway Limitations in Patients With...
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