Maximal Exercise Testing Using the Incremental Shuttle Walking Test Can Be Used to Risk-Stratify Patients with Pulmonary Arterial Hypertension
| Autor: | Allan Lawrie, Abdul G. Hameed, Robin Condliffe, John Harrington, David G. Kiely, Ian A Smith, Catherine Billings, Jim M. Wild, Neil Hamilton, Iain Armstrong, Jennifer Middleton, A. A. Roger Thompson, Athanasios Charalampopoulos, Ian Sabroe, Robert A. Lewis, Judith Hurdman, Matthew Austin, Charlie Elliot, Alexander M.K. Rothman, Andrew J. Swift |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pulmonary Arterial Hypertension Framingham Risk Score business.industry Walking test Editorials Walk Test Exercise capacity medicine.disease Pulmonary hypertension Shuttle walking test Internal medicine Risk stratification Referral centre Cardiology Exercise Test Medicine Humans Maximal exercise business |
| Zdroj: | Annals of the American Thoracic Society |
| ISSN: | 2325-6621 |
| Popis: | Rationale: Exercise capacity predicts mortality in pulmonary arterial hypertension (PAH), but limited data exist on the routine use of maximal exercise testing.Objectives: This study evaluates a simple-to-perform maximal test (the incremental shuttle walking test) and its use in risk stratification in PAH.Methods: Consecutive patients with pulmonary hypertension were identified from the ASPIRE (Assessing the Spectrum of Pulmonary hypertension Identified at a REferral centre) registry (2001-2018). Thresholds for levels of risk were identified at baseline and tested at follow-up, and their incorporation into current risk stratification approaches was assessed.Results: Of 4,524 treatment-naive patients with pulmonary hypertension who underwent maximal exercise testing, 1,847 patients had PAH. A stepwise reduction in 1-year mortality was seen between levels 1 (≤30 m; 32% mortality) and 7 (340-420 m; 1% mortality) with no mortality for levels 8-12 (≥430 m) in idiopathic and connective tissue disease-related PAH. Thresholds derived at baseline of ≤180 m (>10%; high risk), 190-330 m (5-10%; intermediate risk), and ≥340 m ( |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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