| Popis: |
Background: Breathlessness has significant impact on quality-of-life in patients with pulmonary arterial hypertension (PAH) yet few data assess ventilatory responses during day to day activities. In Eisenmenger syndrome (EIS), the additional impact of cyanosis on symptom profiles is even less well described. Method: Fifteen adult patients with idiopathic PAH (IPAH), six with EIS and fifteen age, sex and BMI-matched controls underwent assessment. Participants completed spirometry and four self-paced stair flights wearing portable CPET equipment. BORG dyspnoea scores were collected at rest and completion. Results: Both IPAH and EIS groups had amplified ventilatory responses. Minute ventilation at stair-climb completion was 44±12, 37±15 and 27±9L/min in EIS, IPAH and Controls respectively (p = 0.01). Peak Tv, RR, Tv:FVC ratio, VE/VCO2 slope and ascent time were higher in EIS and IPAH despite similar spirometry and O2 uptake. EIS patients showed immediate decline in end-tidal CO2 and O2 saturations at stair-climb onset. Peak BORG score correlated with stair-climb time (R=0.73, p=0.002), peak end-tidal CO2 (R=-0.73, p=0.001), peak VE (R=0.53, p=0.008), peak RR (R=0.42, p=0.011) and VE/VCO2 (R=0.54, p=0.001) but not with resting or exercise O2 saturations. Conclusion: Increased ventilatory response to stairclimbing in EIS and IPAH drives higher dyspnoea perception relevant to exercise training and recovery times. |
