Long-term changes of exercise hemodynamics and physical capacity in chronic thromboembolic pulmonary hypertension after pulmonary thromboendarterectomy
| Autor: | Lars Bo Ilkjaer, Sten Lyager Nielsen, Søren Mellemkjær, Steen Hvitfeldt Poulsen, Farhad Waziri, Tor Skibsted Clemmensen, Vibeke E. Hjortdal |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cardiac output Hypertension Pulmonary medicine.medical_treatment Hemodynamics Exercise hemodynamics Endarterectomy Pulmonary Artery 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Exertion Exercise Peak exercise Pulmonary thromboendarterectomy business.industry food and beverages medicine.disease Pulmonary hypertension Chronic Disease Cardiology Chronic thromboembolic pulmonary hypertension Pulmonary Embolism Cardiology and Cardiovascular Medicine business |
| Zdroj: | Waziri, F, Mellemkjær, S, Clemmensen, T S, Hjortdal, V E, Ilkjær, L B, Nielsen, S L & Poulsen, S H 2020, ' Long-term changes of exercise hemodynamics and physical capacity in chronic thromboembolic pulmonary hypertension after pulmonary thromboendarterectomy ', International Journal of Cardiology, vol. 317, pp. 181-187 . https://doi.org/10.1016/j.ijcard.2020.05.083 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2020.05.083 |
| Popis: | BACKGROUND: A substantial number of chronic thromboembolic pulmonary hypertension (CTEPH) patients experience dyspnea on exertion and limited exercise capacity despite surgically successful pulmonary endarterectomy (PEA). We sought to prospectively evaluate resting and peak exercise hemodynamics before, 3 and 12 months after PEA in consecutive CTEPH-patients and correlate it to physical functional capacity.METHODS AND RESULTS: Twenty consecutive CTEPH-patients were examined. Twelve months after PEA, 75% of patients with severely increased pre-PEA mean pulmonary arterial pressure (mPAP) at rest had normal or mildly increased mPAP. However, mPAP reduction was less pronounced during exercise where only 45% had normal or mildly increased mPAP at 12 months. Hemodynamic changes during exercise were tested using the pressure-flow relationship (i.e. mPAP/cardiac output (CO) slope). The average mPAP/CO slope was 7.5 ± 4.2 mm Hg/L/min preoperatively and 3.9 ± 3.0 mm Hg/L/min at 12 months (p CONCLUSION: Invasive exercise hemodynamic examination in CTEPH-patients demonstrates that after otherwise successful PEA surgery, >50% of patients have a significant increase in exercise mPAP, and the CO reserve remains compromised 12 months after PEA. Improvement in physical capacity is correlated with ∆CO. |
| Databáze: | OpenAIRE |
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