Usefulness of cardiopulmonary exercise test combined with exercise stress echocardiography in mild chronic thromboembolic pulmonary disease.
Purpose: Chronic thromboembolic pulmonary disease (CTEPD) can lead to exercise limitations even without right ventricular (RV) dysfunction or pulmonary hypertension at rest. Combining exercise stress echocardiography with cardiopulmonary exercise testing (ESE‐CPET) for RV function and pressure chang...
| Publicado en: | Echocardiography Vol. 41; no. 3; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176274012&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176274012 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Mar2024 vid: 41 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 176274012 176274012 176274012 10.1111/echo.15795 176274012 ppf: 1 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Usefulness of cardiopulmonary exercise test combined with exercise stress echocardiography in mild chronic thromboembolic pulmonary disease. aug: au: Kim, Min Sun Jeon, Kina Kim, Eun Kyoung Park, Taek Kyu Park, Hye Yun Yang, Jeong Hoon Park, Sung‐Ji Lee, Sang‐Chol Park, Seung Woo Kim, Duk‐Kyung Chang, Sung‐A affil: Division of Cardiology, Department of Medicine, Heart Vascular Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea sug: subj: Exercise Test, Cardiopulmonary Echocardiography Methods Pulmonary Embolism Ultrasonography Thromboembolism Ultrasonography Chronic Disease Ultrasonography Exercise Physiology Cardiopulmonary Physiology Ventricular Function, Right Physiology Hypertension, Pulmonary Ultrasonography Human Pulmonary Wedge Pressure Hemodynamics Heart Catheterization Oxygen Consumption Predictive Value of Tests Oxygen Saturation Pretest-Posttest Design Global Longitudinal Strain Descriptive Statistics ab: Purpose: Chronic thromboembolic pulmonary disease (CTEPD) can lead to exercise limitations even without right ventricular (RV) dysfunction or pulmonary hypertension at rest. Combining exercise stress echocardiography with cardiopulmonary exercise testing (ESE‐CPET) for RV function and pressure changes combined measuring overall function may be useful for CTEPD evaluation. This study aims to investigate CPET and ESE results to elucidate the mechanisms of exercise limitation in mild CTEPD cases. Methods: Among our CTEPD registry, 50 patients who performed both right heart catheterization data of mild disease (less than 30 mm Hg of mean pulmonary arterial pressure (mPAP)) and ESE‐CPET were enrolled. Echocardiography and CPET‐derived parameters were compared with hemodynamic parameters measured through right heart catheterization. Results: Peak VO2 (maximal oxygen consumption) was decreased in overall population (71.3 ± 16.3% of predictive value). Peak VO2 during exercise was negatively correlate with mPAP and pulmonary vascular resistance at rest. A substantial increase in RV systolic pressure (RVSP) was observed during exercise (RVSP: pre‐exercise 37.2 ± 11.8 mm Hg, postexercise 64.3 ± 24.9 mm Hg, p‐value <.001). Furthermore, RV function deteriorated during exercise when compared to the baseline (RV fractional area change: 31.5 ± 10.0% to 37.8 ± 7.0%, p‐value <.001; RV global longitudinal strain: −17.1 ± 4.2% to −17.7 ± 3.3%, p‐value <.001) even though basal RV function was normal. While an excessive increase in RVSP during exercise was noticed in both groups, dilated RV and RV dysfunction during exercise were demonstrated only in the impaired exercise capacity group. Conclusion: CTEPD patients with mild PH or without PH exhibited limited exercise capacity alongside an excessive increase in RVSP during exercise. Importantly, RV dysfunction during exercise was significantly associated with exercise capacity. ESE‐CPET could aid in comprehending the primary cause of exercise limitation in these patients. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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