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

Abstract

None of the established prognostic factors includes measurement of pulmonary haemodynamics during exercise. In a prospective study, we evaluated the prognostic value of exercise pulmonary haemodynamics.
Forty-three patients (22 women) with an age of 55 years (median) [interquartile range (IQR) 46: 68] were included. Right heart catheterization was performed at rest and during an exercise (10-40 W) in the 43 patients. At diagnosis, NYHA functional classes were I/II, III and IV in 7, 21 and 15 patients, respectively. Pulmonary haemadynamic data at rest were mean pulmonary artery pressure 50 mm Hg [43: 58], cardiac index 1.88 L/min/m ² [1.59: 2.21] and pulmonary vascular resistance of 1067 dyn.s.cm ^-5 [779: 1394]. All patients were treated according to international guidelines at diagnosis and at follow up visits. Baseline exercise cardiac index was significantly lower in functional class IV (1.99 [1.53: 3.09]) compared to functional class III patients (2.43 [2.03: 2.85]) and in functional class III compared to functional class I/II patients (3.28 [2.56: 4.41]) (p=0.024). Exercise cardiac index was also significantly lower in patients with a 6-minute walk distance < 360 meters (median) (2.09 [1.58: 2.13] versus 2.59 [2.13: 3.34], p=0.041). In a proportional hazard analysis, exercise cardiac index was the best predictor of death with a hazard ratio of 7.5 (95% confidence interval 2.3: 24.3, p=0.001).
Exercise cardiac index is a good predictor of exercise capacity. This variable was also the best survival prognostic factor in our group of patients.

Rating:

Share or cite this content

Citations should be made in the following way:
R. Poncot-Mongars, A. Chaouat, P. Malvestio, E. Gomez, D. Regent, C. Selton, A. Guillaumot, F. Chabot (Vandoeuvre-lès-Nancy, France). Role of exercise cardiac index to predict NYHA functional class, 6-minute walk test distance and survival in idiopathic, heritable and anorexigen-associated pulmonary arterial hypertension. Eur Respir J 2011; 38: Suppl. 55, 2300

Member's Comments

No comment yet.

Related content which might interest you: Exercise testing to predict outcome in idiopathic versus associated pulmonary arterial hypertension Source: Eur Respir J 2012; 40: 1410-1419 Year: 2012 The role of per cent predicted 6-min walk distance in pulmonary arterial hypertension Source: Eur Respir J 2010; 36: 1294-1301 Year: 2010 Heart rate responses during the 6-minute walk test in pulmonary arterial hypertension Source: Eur Respir J 2006; 27: 114-120 Year: 2006 Maximal cardiopulmonary exercise testing in mildly symptomatic patients with idiopathic pulmonary arterial hypertension: correlations with 6-min walk distance and resting hemodynamics Source: Annual Congress 2009 - Pulmonary vascular diseases Year: 2009 The 6-min walk distance: change over time and value as a predictor of survival in severe COPD Source: Eur Respir J 2004; 23: 28-33 Year: 2004 The need to move from 6-minute walk distance to outcome trials in pulmonary arterial hypertension Source: Eur Respir Rev 2013; 22: 487-494 Year: 2013 The prognostic value of percent predicted six-minute walk distance in pulmonary arterial hypertension Source: Annual Congress 2009 - Clinical management of pulmonary arterial hypertension Year: 2009 Is 6-minute walk distance (6MWD) associated with long-term outcomes in pulmonary arterial hypertension (PAH)? Results from SERAPHIN Source: Annual Congress 2013 –Pulmonary circulation: clinical science and treatment Year: 2013 The 6-minute walk test adjusted for peak heart rate correlates with stroke volume index in pulmonary arterial hypertension Source: Annual Congress 2004 - Pulmonary hypertension Year: 2004 6-minute walk distance as a predictor of outcome in idiopathic pulmonary fibrosis Source: Eur Respir J 2014; 43: 1822-1823 Year: 2014 6-minute walk distance as a predictor of outcome in idiopathic pulmonary fibrosis Source: Eur Respir J 2014; 43: 1823-1824 Year: 2014 Cardiopulmonary exercise test unveils abnormal exercise physiology in patients affected by pulmonary arterial hypertension with a low-risk profile 6 minute walk distance. Source: Virtual Congress 2020 – Exercise and haemodynamics in pulmonary hypertension Year: 2020 6-minute walk distance is an independent predictor of mortality in patients with idiopathic pulmonary fibrosis Source: Eur Respir J 2014; 43: 1421-1429 Year: 2014 6-minute walk test predicts pulmonary artery pressure in patients with collagen vascular disease associated interstitial pneumonia Source: Annual Congress 2012 - Diffuse parenchymal lung disease II Year: 2012 Effects of sildenafil on 6-minute walk distance (6MWD) and WHO functional class (FC) in pulmonary arterial hypertension (PAH) patients after 1 year of treatment Source: Annual Congress 2005 - Treatment of pulmonary arterial hypertension Year: 2005 Physiological response to the six-minute walk test in pulmonary arterial hypertension Source: Eur Respir J 2005; 26: 667-672 Year: 2005 Exercise testing in pulmonary arterial hypertension and in chronic heart failure Source: Eur Respir J 2004; 23: 747-751 Year: 2004 Relationship between sit-to-stand test and six-minute walk test in patients with pulmonary arterial hypertension Source: International Congress 2015 – The challenge of choosing the best physical and functional assessment methods Year: 2015 Spiroveloergometry and 6-minute walking test for exercise capacity assessment in patients with primary pulmonary hypertension Source: Eur Respir J 2005; 26: Suppl. 49, 16s Year: 2005 The clinical relevance of heart rate increase in the interpretation of six-minute walk test in pulmonary hypertension Source: Annual Congress 2012 - Pulmonary circulation: clinical end-points and clinical physiology Year: 2012