Open AccessLack of concordance between the different exercise test measures used in the risk stratification of patients with pulmonary arterial hypertension
Author(s) -
Mora Cuesta Víctor M.,
Martínez Meñaca Amaya,
Iturbe Fernández David,
Tello Mena Sandra,
Alonso Lecue Pilar,
Fernández Márquez Daniel,
SáinzEzquerra Belmonte Begoña,
Gallardo Ruiz María José,
Cifrián Martínez José Manuel
Publication year - 2022
Publication title -
pulmonary circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 40
ISSN - 2045-8940
DOI - 10.1002/pul2.12149
Subject(s) - concordance , medicine , risk stratification , stratification (seeds) , cohort , retrospective cohort study , test (biology) , cardiopulmonary exercise test , physical therapy , risk assessment , cardiology , emergency medicine , vo2 max , blood pressure , heart rate , seed dormancy , paleontology , botany , germination , dormancy , biology , computer security , computer science
Abstract In pulmonary arterial hypertension (PAH) patients it is essential to perform a prognostic assessment to optimize the treatment. The aim of this study is to evaluate the risk stratification concordance assessed with different exercise test variables in a cohort of PAH patients. A retrospective analysis was performed using patient data registered in the PAH unit. Only those patients in whom the mean time elapsed between the 6‐min walking test (6MWT) and the cardiopulmonary exercise test (CPET) was a maximum of 6 months were selected. A total of 140 records from 40 patients were finally analyzed. When it came to assessing the concordance between the two exercise tests in the guidelines (CPET and 6MWT), up to 84.3% of the records did not coincide in terms of the risk stratification. Exclusively considering the CPET parameters, most of the records (75%) failed to include all three variables in the same risk category. When analyzing the VO 2 alone, up to 40.7% of the tests yielded different risk classifications depending on whether the parameter was expressed. In conclusion, there is a low concordance between the two proposed exercise tests. These results should be a call for reflection on whether the cut‐off points set for the exercise tests proposed for the current risk stratification are adequate to achieve a correct risk stratification or whether they require an appropriate revision.