Open AccessCharacteristics of cardiopulmonary exercise testing of patients with borderline mean pulmonary artery pressure
Author(s) -
Jiang Rong,
Liu Hui,
Pudasaini Bigyan,
Zhang Rui,
Xu JianLin,
Wang Lan,
Zhao QinHua,
Yuan Ping,
Guo Jian,
He Jing,
Gong SuGang,
Wu Cheng,
Wu WenHui,
Luo CiJun,
Qiu HongLing,
Jing ZhiCheng,
Liu JinMing
Publication year - 2019
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12996
Subject(s) - medicine , oxygen pulse , anaerobic exercise , pulmonary artery , cardiology , hemodynamics , vo2 max , pulmonary hypertension , pulmonary function testing , logistic regression , vascular resistance , blood pressure , heart rate , physical therapy
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 VO 2 at the anaerobic threshold and peak VO 2 /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 VO 2 /kg. Conclusions Patients with boPAP have a greater prevalence of exercise intolerance, a trend of impaired oxygen pulse and submaximal exercise tolerance.