Figures
- FIGURE 1
Flow diagram of patient population for study inclusion. PAH: pulmonary arterial hypertension.
- FIGURE 2
Haemodynamic and oxygen parameters during cardiopulmonary exercise testing in patients with pulmonary arterial hypertension. a) mean pulmonary arterial pressure (mPAP); b) cardiac index; c) total pulmonary resistance (TPR); d) peripheral arterial oxygen saturation (SpO2).
- FIGURE 3
The mean pulmonary arterial pressure (mPAP)/cardiac output slope during cardiopulmonary exercise testing in patients with pulmonary arterial hypertension. The broken line represents mPAP at rest of 30 mmHg and the dotted line represents the mPAP/cardiac output slope of 3 mmHg·min·L−1.
- FIGURE 4
Correlation between the mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope and parameters during cardiopulmonary exercise testing in patients with pulmonary arterial hypertension. a) Minute ventilation (V′E)/carbon dioxide output (V′CO2) slope; b) peripheral arterial oxygen saturation (SpO2)/workload slope. The continuous lines indicate the regression lines.
Tables
- TABLE 1
Patient characteristics
Baseline Study enrolment p-value Male/female 3/29 Age years 28.5±10.3 33.0±10.1 <0.01 Body mass index kg·m−2 20.7±3.0 19.8±2.6 0.09 WHO functional class# (I/II/III/IV) III (0/6/14/12) II (7/25/0/0) <0.01 PAH-specific therapy Intravenous epoprostenol 1 (3) 26 (81) <0.01 Beraprost 11 (34) 5 (16) 0.18 Endothelin receptor antagonist 9 (28) 30 (94) <0.01 Phosphodiesterase type 5 inhibitor 6 (19) 21 (66) <0.01 Soluble guanylate cyclase stimulator 0 (0) 1 (3) Combination therapy Dual therapy 2 (6) 13 (41) <0.01 Triple therapy 4 (13) 19 (59) <0.01 Laboratory parameters BNP pg·mL−1 334.5 (8.7–1687.6) 10.3 (5.8–131.7) <0.01 Respiratory parameters Vital capacity % predicted 89.9±17.2 93.7±14.4 0.03 FEV1/FVC % 84.1±7.3 82.5±7.2 0.24 DLCO % predicted 58.5±12.6 66.3±10.8 <0.01 Pulmonary haemodynamic parameters PAWP mmHg 8.3±3.4 7.9±3.2 0.57 mPAP mmHg 61.8±18.3 28.7±12.2 <0.01 Cardiac index L·min−1·m−2 2.17±0.66 3.59±0.89 <0.01 PVR Wood units 18.3±8.0 4.3±2.9 <0.01 Exercise capacity 6MWD m 287.3±117.1 449.7±69.2 <0.01 Data are presented as n, mean±sd, n (%) or median (range), unless otherwise stated. WHO: World Health Organization; PAH: pulmonary arterial hypertension; BNP: brain natriuretic peptide; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; DLCO: diffusing capacity of the lung for carbon monoxide; PAWP: pulmonary artery wedge pressure; mPAP: mean pulmonary arterial pressure; PVR: pulmonary vascular resistance; 6MWD: 6-min walk distance. #: median (n).
- TABLE 2
Haemodynamic and oxygen parameters during cardiopulmonary exercise testing
Rest Peak exercise Change p-value sBP mmHg 104.0±10.4 127.8±19.4 +23 <0.01 Heart rate bpm 82.4±12.0 121.9±14.7 +50 <0.01 mRAP mmHg 3.6±2.0 6.4±2.2 +121 <0.01 mPAP mmHg 27.9±10.7 45.9±16.7 +67 <0.01 Cardiac index L·min−1·m−2 3.72±0.85 5.35±1.20 +46 <0.01 TPR Wood units 5.74±3.42 6.58±3.82 +17 <0.01 SpO2 % 97.0±1.2 94.0±2.7 −3.1 <0.01 SvO2 % 76.8±4.2 53.5±7.6 −30 <0.01 Data are presented as mean±sd or %. sBP: systolic blood pressure; mRAP: mean right atrial pressure; mPAP: mean pulmonary arterial pressure; TPR: total pulmonary resistance; SpO2: peripheral arterial oxygen saturation; SvO2: mixed venous oxygen saturation.
- TABLE 3
Respiratory parameters during cardiopulmonary exercise testing
Peak V′O2 mL·min−1 658.5±147.8 Peak V′O2/weight mL·min−1·kg−1 14.3±3.7 Peak V′O2/weight % predicted 53.8±13.5 V′O2 at AT mL·min−1 533.3±106.0 V′O2 at AT/weight mL·min−1·kg−1 11.6±2.5 V′O2 at AT/weight % predicted 70.8±15.4 V′E/V′CO2 slope mL·mL−1 31.7±5.2 Data are presented as mean±sd. V′O2: oxygen uptake; AT: anaerobic threshold; V′E: minute ventilation; V′CO2: carbon dioxide output.
- TABLE 4
Correlation between the mean pulmonary arterial pressure (mPAP)/cardiac output slope and parameters at rest and during the exercise
r p-value At rest mPAP 0.73 <0.01 Cardiac index −0.15 0.41 TPR 0.64 <0.01 SpO2 −0.03 0.89 SvO2 −0.15 0.42 Vital capacity 0.33 0.07 FEV1/FVC −0.15 0.42 DLCO 0.05 0.78 At peak exercise mPAP 0.70 <0.01 Cardiac index −0.60 <0.01 TPR 0.80 <0.01 SpO2 −0.19 0.29 SvO2 −0.15 0.40 TPR: total pulmonary resistance; SpO2: peripheral arterial oxygen saturation; SvO2: mixed venous oxygen saturation; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; DLCO: diffusing capacity of the lung for carbon monoxide.
Supplementary Material
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Supplementary material 00725-2020.supplement
