Premium
Exercise capacity in idiopathic pulmonary fibrosis: The effect of pulmonary hypertension
Author(s) -
BOUTOU AFRODITI K,
PITSIOU GEORGIA G.,
TRIGONIS IOANNIS,
PAPAKOSTA DESPINA,
KONTOU PASCHALINA K.,
CHAVOUZIS NIKOLAOS,
NAKOU CHRYSANTHI,
ARGYROPOULOU PARASKEVI,
WASSERMAN KARLMAN,
STANOPOULOS IOANNIS
Publication year - 2011
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2010.01909.x
Subject(s) - medicine , anaerobic exercise , pulmonary hypertension , pulmonary function testing , cardiology , idiopathic pulmonary fibrosis , oxygen pulse , vo2 max , lung , blood pressure , heart rate , physical therapy
Background and objective: Increased pulmonary arterial pressure (PAP) usually coexists with impaired lung function in IPF. Data on the effect of pulmonary hypertension (PH) on cardiopulmonary responses during exercise in IPF patients is very limited. We sought to investigate the impact of PH on exercise capacity and the correlation between systolic PAP (sPAP) and pulmonary function testing, as well as cardiopulmonary exercise parameters, in patients with IPF and PH. Methods: Eighty‐one consecutive patients with IPF, who were evaluated over a 6‐year period, were retrospectively studied. Patients underwent pulmonary function testing, Doppler echocardiography and maximal cardiopulmonary exercise testing. PH was defined as sPAP > 35 mm Hg. Results: PH was diagnosed in 57% of the patients. Categorization of patients according to severity of PH indicated a significant reduction in maximum work rate, peak O 2 uptake, anaerobic threshold and peak O 2 pulse in those with sPAP > 50 mm Hg. In IPF patients with PH, estimated sPAP correlated with peak O 2 uptake, anaerobic threshold, peak O 2 pulse and end‐tidal CO 2 at anaerobic threshold, while the strongest correlation was between sPAP and ventilatory equivalent for CO 2 at anaerobic threshold ( r = 0.611, P < 0.001). There were no differences in pulmonary function or exercise parameters indicative of lung volume reduction, across the patient categories, and none of these parameters correlated with sPAP. Conclusions: PH has a negative impact on exercise capacity in IPF patients. In IPF patients with PH, resting sPAP correlated with exercise parameters indicative of gas exchange and circulatory impairment, but not with defective lung mechanics.