Reduced exercise capacity in patients with systemic sclerosis is associated with lower peak tissue oxygen extraction: a cardiovascular magnetic resonance-augmented cardiopulmonary exercise study
| Autor: | Tushar Kotecha, Christopher P. Denton, J. Gerry Coghlan, Vivek Muthurangu, James T Brown, Marianna Fontana, Jennifer A. Steeden, Daniel S Knight |
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| Rok vydání: | 2021 |
| Předmět: |
Cardiac output
medicine.medical_specialty Magnetic Resonance Spectroscopy Supine position chemistry.chemical_element Exercise intolerance Pulmonary arterial hypertension Oxygen Predictive Value of Tests Internal medicine medicine Humans Diseases of the circulatory (Cardiovascular) system Radiology Nuclear Medicine and imaging Exercise Connective tissue disease Angiology Exercise Tolerance Scleroderma Systemic Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Research Magnetic resonance imaging Stroke volume medicine.disease Pulmonary hypertension Cardiopulmonary exercise testing chemistry RC666-701 Exercise Test Cardiology Systemic sclerosis Cardiovascular magnetic resonance medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-12 (2021) Journal of Cardiovascular Magnetic Resonance |
| ISSN: | 1532-429X |
| Popis: | Background Exercise intolerance in systemic sclerosis (SSc) is typically attributed to cardiopulmonary limitations. However, problems with skeletal muscle oxygen extraction have not been fully investigated. This study used cardiovascular magnetic resonance (CMR)-augmented cardiopulmonary exercise testing (CMR-CPET) to simultaneously measure oxygen consumption and cardiac output. This allowed calculation of arteriovenous oxygen content gradient, a recognized marker of oxygen extraction. We performed CMR-CPET in 4 groups: systemic sclerosis (SSc); systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH); non-connective tissue disease pulmonary hypertension (NC-PAH); and healthy controls. Methods We performed CMR-CPET in 60 subjects (15 in each group) using a supine ergometer following a ramped exercise protocol until exhaustion. Values for oxygen consumption, cardiac output and oxygen content gradient, as well as ventricular volumes, were obtained at rest and peak-exercise for all subjects. In addition, T1 and T2 maps were acquired at rest, and the most recent clinical measures (hemoglobin, lung function, 6-min walk, cardiac and catheterization) were collected. Results All patient groups had reduced peak oxygen consumption compared to healthy controls (p Conclusions Reduced peak oxygen consumption in SSc patients is predominantly driven by reduced oxygen content gradient and in SSc-PAH patients this was amplified by reduced peak cardiac output. Trial registration The study is registered with ClinicalTrials.gov Protocol Registration and Results System (ClinicalTrials.gov ID: 100358). |
| Databáze: | OpenAIRE |
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