Submaximal exercise pulmonary gas exchange in left heart disease patients with different forms of pulmonary hypertension
| Autor: | Michael R. Smetana, Bryan J. Taylor, Bruce D. Johnson, Robert P. Frantz |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Right heart catheterization
Adult Male medicine.medical_specialty Hypertension Pulmonary Hemodynamics Submaximal exercise Article Oxygen Consumption Internal medicine medicine Humans Exercise Aged Heart Failure business.industry Pulmonary Gas Exchange Middle Aged medicine.disease Pulmonary hypertension Blood pressure Heart failure Breathing Cardiology Female Cardiology and Cardiovascular Medicine business Transpulmonary pressure |
| Popis: | Background We determined whether pulmonary gas exchange indices during submaximal exercise are different in heart failure (HF) patients with combined post- and pre-capillary pulmonary hypertension (PPC-PH) versus HF patients with isolated post-capillary PH (IPC-PH) or no PH. Methods and Results Pulmonary hemodynamics and pulmonary gas exchange were assessed during rest and submaximal exercise in 39 HF patients undergoing right heart catheterization. After hemodynamic evaluation, patients were classified as having no PH (n = 11), IPC-PH (n = 12), or PPC-PH (n = 16). At an equivalent oxygen consumption, end-tidal CO2 (PETCO2) and arterial oxygen saturation (SaO2) were greater in no-PH and IPC-PH versus PPC-PH patients (36.1 ± 3.2 vs 31.7 ± 4.5 vs 26.2 ± 4.7 mm Hg and 97 ± 2 vs 96 ± 3 vs 91 ± 1%, respectively). Conversely, dead-space ventilation (VD/VT) and the ventilatory equivalent for carbon dioxide ( V ˙ E / V ˙ CO 2 ratio ) were lower in no-PH and IPC-PH versus PPC-PH patients (0.37 ± 0.05 vs 0.38 ± 0.04 vs 0.47 ± 0.03 and 38 ± 5 vs 42 ± 8 vs 51 ± 8, respectively). The exercise-induced change in VD/VT, V ˙ E / V ˙ CO 2 ratio, and PETCO2 correlated significantly with the change in mean pulmonary arterial pressure, diastolic pressure difference, and transpulmonary pressure gradient in PPC-PH patients only. Conclusions Noninvasive pulmonary gas exchange indices during submaximal exercise are different in HF patients with combined post- and pre-capillary PH compared with patients with isolated post-capillary PH or no PH. |
| Databáze: | OpenAIRE |
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