Exercise hyperventilation and pulmonary gas exchange in chronic thromboembolic pulmonary hypertension: Effects of balloon pulmonary angioplasty.
balloon pulmonary angioplasty
cardiopulmonary exercise test
chronic thromboembolic pulmonary hypertension
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
13
04
2021
revised:
25
08
2021
accepted:
14
09
2021
pubmed:
8
11
2021
medline:
11
3
2022
entrez:
7
11
2021
Statut:
ppublish
Résumé
Excessive ventilation (V̇E) and abnormal gas exchange during exercise are features of chronic thromboembolic pulmonary hypertension (CTEPH). In selected CTEPH patients, balloon pulmonary angioplasty (BPA) improves symptoms and exercise capacity. How BPA affects exercise hyperventilation and gas exchange is poorly understood. In this longitudinal observational study, symptom-limited cardiopulmonary exercise tests and carbon monoxide lung diffusion (DLCO) were performed before and after BPA (interval, mean (SD): 3.1 (2.4) months) in 36 CTEPH patients without significant cardiac and/or pulmonary comorbidities. Peak work rate improved by 20% after BPA whilst V̇E at peak did not change despite improved ventilatory efficiency (lower V̇E with respect to CO Ventilatory efficiency, physiological VD/VT, and pulmonary gas exchange improved after BPA. The fact that DLCO did not change suggests that the pulmonary capillary blood volume and probably the true alveolar dead space were unaffected by BPA. The correlation between DLCO measured before BPA and P(Ai-a)O
Sections du résumé
BACKGROUND
Excessive ventilation (V̇E) and abnormal gas exchange during exercise are features of chronic thromboembolic pulmonary hypertension (CTEPH). In selected CTEPH patients, balloon pulmonary angioplasty (BPA) improves symptoms and exercise capacity. How BPA affects exercise hyperventilation and gas exchange is poorly understood.
METHODS
In this longitudinal observational study, symptom-limited cardiopulmonary exercise tests and carbon monoxide lung diffusion (DLCO) were performed before and after BPA (interval, mean (SD): 3.1 (2.4) months) in 36 CTEPH patients without significant cardiac and/or pulmonary comorbidities.
RESULTS
Peak work rate improved by 20% after BPA whilst V̇E at peak did not change despite improved ventilatory efficiency (lower V̇E with respect to CO
CONCLUSIONS
Ventilatory efficiency, physiological VD/VT, and pulmonary gas exchange improved after BPA. The fact that DLCO did not change suggests that the pulmonary capillary blood volume and probably the true alveolar dead space were unaffected by BPA. The correlation between DLCO measured before BPA and P(Ai-a)O
Identifiants
pubmed: 34742646
pii: S1053-2498(21)02504-3
doi: 10.1016/j.healun.2021.09.009
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-79Informations de copyright
Copyright © 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure statement MBN, NP, AG, SD, MS, FT, CA, HB report no disclosures. CP reports personal fees from Boehringer Ingelheim, Glaxo Smith Kline, Astra Zeneca and Sanofi outside submitted work. BA reports honoraria and consulting fees grant funding from Boehringer Ingelheim, Glaxo Smith Kline, Menarini, Chiesi, Astra Zeneca and Sanofi unrelated to the submitted work. BD reports grant funding from Novartis and honoraria and consulting fees from Boehringer Ingelheim, Nuvaira, Menarini, Chiesi, Glaxo Smith Kline, Astra Zeneca and Sanofi unrelated to the submitted work.