Source: Annual Congress 2011 - Physiology of human pulmonary hypertension
Disease area: Pulmonary vascular diseases

Abstract

Background. Mixed venous oxygen pressure (PvO2) is a reflection of the tissue oxygenation state. PvO2 is one of the variables associated to survival in patients with pulmonary arterial hypertension (PAH).
Objectives. Investigate if the relationship CI – PvO2 during the vasodilatation challenge (VC) is maintained and whether the type of response has any prognostic implication in PAH patients.
Methods. We analyzed the hemodynamic and gasometrical variables at baseline and during the response to the acute VC at right heart catheterization of patients with PAH. According to the results, patients were judged to have an appropriate response (AR) (i.e. higher CI=higher PvO2) or not. The midterm survival in both groups was also analyzed.
Results. We studied 42 patients with PAH (35±5 years); 75% female. For the drug challenge we used adenosine (n=33) and Iloprost (n=9). Patients with AR (n=31) had a significant correlation CI-PvO2 at baseline and during challenge (r=0.67; and 0.52; respectively, p<0.05). In patients with inappropriate response (IR) (n= 11) the correlation was significant at baseline (r=0.59; p< 0.05) but it was lost during challenge (r=0.2; p=NS). The correlation delta CI-delta PvO2 was positive (r=0.44; p<0.05) for those with AR and it was negative for those with IR (r= - 0.5; p<0.05). In a preliminary analysis, 5-year mortality appears higher in those with an IR (27.2 versus 15%)
Conclusions. Some patients with PAH have an abnormal tissue oxygenation, which may be uncovered by the analysis of the CI-PvO2 relationship. This finding may be of prognostic significance.

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Citations should be made in the following way:
C. Rosado-Bosque, T. Pulido, K. Zamora, A. Rodriguez, M. Contreras, P. Guevara, J. Sandoval (Mexico City, Mexico). Analysis of the cardiac index-PvO2 relationship during vasodilatation challenge as a prognostic factor in pulmonary arterial hypertension. Eur Respir J 2011; 38: Suppl. 55, 2302

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