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Factors affecting the response to exercise in patients with severe pulmonary arterial hypertension.

Abstract：

INTRODUCTION:Ergospirometry objectively quantifies exercise capacity. Up until now, the response to exercise evaluated by ergospirometry in patients with pulmonary arterial hypertension has only been described in recently diagnosed.patients. Our aim is to describe the response to exercise in patients with severe pulmonary arterial hypertension under specific treatment and define which parameters determine their exercise capacity. PATIENTS AND METHOD:A cross-sectional study was performed on 80 patients, 57 women, aged 45 (14), with severe pulmonary arterial hypertension (48 idiopathic, 14 related to toxic rapeseed oil, 13 to connective tissue disease, 5 to human immunodeficiency virus), mean pulmonary pressure at diagnosis 61(15)mmHg and after 49(33) months under treatment since diagnosis. Biomarkers were measured and echocardiography and ergospirometry were performed the same day. RESULTS:Our patients, under specific treatment, showed the typical behaviour of patients with pulmonary arterial hypertension with less limitation of both aerobic capacity and ventilatory efficiency. Being male (p=0.004), high ventilatory equivalent for carbon dioxide at anaerobic threshold (p<0.001) or biomarkers (p=0.006) were the strongest predictors of impaired peak oxygen uptake in multivariate analysis, whereas for an impaired percentage achieved of predicted value were right ventricle diastolic diameter (p<0.001), months of treatment (p=0.01) and high ventilatory equivalent for CO(2) (p<0.001). CONCLUSIONS:In pulmonary arterial hypertension, right ventricle dysfunction (expressed by its dilation or high NTproBNP) and impaired ventilatory inefficiency as well as being male or a short time under treatment can be considered as determining factors of impaired exercise capacity.

journal_name

Arch Bronconeumol

journal_title

Archivos de bronconeumologia

authors

Flox-Camacho A,Escribano-Subías P,Jiménez-López Guarch C,Fernández-Vaquero A,Martín-Ríos D,de la Calzada-Campo CS

doi

10.1016/j.arbres.2010.07.013

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

10-6

issue

1

eissn

0300-2896

issn

1579-2129

pii

S0300-2896(10)00232-2

journal_volume

47

pub_type

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