Associations of Exercise Tolerance With Hemodynamic Parameters for Pulmonary Arterial Hypertension and for Chronic Thromboembolic Pulmonary Hypertension

Tsuboi, Yasunori; Tanaka, Hidekazu; Nishio, Ryo; Sawa, Takuma; Terashita, Daisuke; Nakayama, Keiichi I.; Satomi‐Kobayashi, Seimi; Sakai, Yoshitada; Emoto, Noriaki; Hirata, Ken‐ichi

doi:10.1097/hcr.0000000000000257

Cited by 10 publications

(12 citation statements)

References 23 publications

(24 reference statements)

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“…6MWD and cardiopulmonary exercise test (CPET) were evaluated for exercise tolerance. 24 Pulmonary function was evaluated by measuring vital capacity as a percentage of predicted vital capacity (%VC), the ratio of forced expiratory through the femoral vein. A 6-Fr guiding catheter was engaged into the targeting sectional branches and a 0.014inch guide wire was crossed through the lesion.…”

Section: Clinical Parametersmentioning

confidence: 99%

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension　― Similar Effects on Health-Related Quality of Life ―

et al. 2019

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balloon pulmonary angioplasty (BPA) was introduced, which had similarly beneficial effects on hemodynamics, exercise tolerance, and prognosis in patients with inoperable or surgically inaccessible disease. 7-12 In spite of the progress in therapeutic options, some patients who have undergone PEA or BPA still had residual symptoms. 13,14 Health-related quality of life (HRQOL) measurement is a subjective outcome that represents disease impact on a person's function and wellbeing, and can be altered by disease treatment. 15,16 Beyond objective outcomes such as C hronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterized by fibrothrombotic obstructions of the pulmonary arteries (PA), resulting in increased pulmonary vascular resistance (PVR), pulmonary vascular remodeling and eventually leading to right ventricular failure. 1 The primary therapy for CTEPH has been pulmonary endarterectomy (PEA), 2 which contributes to better hemodynamics, oxygenation, exercise capacity, and prognosis. 3,4 CTEPH prognosis had been poor until the development of PEA. 5,6 Subsequently,

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Section: Clinical Parametersmentioning

confidence: 99%

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension　― Similar Effects on Health-Related Quality of Life ―

et al. 2019

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“…Several papers have been recently published investigating the role of CPET in PH 5,6 and all of them showed a close relation between CPET and outcome. The principal findings of this study are substantially in line with abovecited reports, but we found a specific correlation among Ve/ VCO slope, DPG and pulmonary vascular resistance.…”

Section: Discussionmentioning

confidence: 98%

Cardiopulmonary exercise test predicts right heart catheterization

Correale

Tricarico

Ferraretti

et al. 2017

Eur J Clin Investigation

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“…Surie et al examined RV response to exercise with CMR in 13 CTEPH patients and 12 months after PEA; however, the patients exercised only at 40% of maximal workload . Other studies are retrospective, with the absence of simultaneous echocardiography or CMR imaging during exercise . Thus, our study adds new information by including consecutive CTEPH patients undergoing PEA, by using more advanced and newer echocardiographic modalities at rest and by studying the relationship between RV systolic function and physical capacity using maximal workload.…”

Section: Discussionmentioning

confidence: 98%

Long‐term changes of resting and exercise right ventricular systolic performance in patients with chronic thromboembolic pulmonary hypertension following pulmonary thromboendarterectomy – A two‐dimensional and three‐dimensional echocardiographic study

et al. 2019

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Aims To characterize right ventricular (RV) geometry and function in chronic thromboembolic pulmonary hypertension (CTEPH) patients at rest and during exercise before pulmonary thromboendarterectomy (PEA), and at 3 and 12 months after PEA using two‐dimensional and three‐dimensional echocardiography with reference to clinical performance and exercise capacity. Methods and results Forty subjects (20 CTEPH patients and 20 controls) were enrolled between December 2014 and January 2017. Three‐dimensional echocardiography demonstrated a significant reduction and normalization of end‐diastolic and end‐systolic RV volumes in CTEPH patients 12 months after PEA. RV systolic function improved after PEA; however, tricuspid annular plane systolic excursion (TAPSE) (baseline 18 ± 6 mm vs 15 ± 3 mm at 12 months after PEA, P < .05) and tricuspid lateral annular systolic velocity (RV‐S′) (baseline −8.3 ± 2.1 cm/s vs −7.2 ± 1.3 cm/s at 12 months after PEA, P < .05) declined significantly after PEA. Tricuspid regurgitation gradient was 64 ± 21 mm Hg at baseline, 40 ± 14 mm Hg at 3 months, and 30 ± 13 at 12 months, P < .00001. RV free‐wall longitudinal strain at peak exercise was significantly increased from baseline (−10.6 ± 5.5%) to 12 months of follow‐up (−15.8 ± 5.2%), P < .005. Physical exercise capacity, measured as peak oxygen uptake, was significantly increased and correlated directly with improvement of resting and exercise‐induced RV‐EF. Conclusion Improvement of RV geometry and systolic function, along with the reduction of systolic pulmonary pressure, can be expected following PEA in CTEPH patients during long‐term follow‐up. Improvement of RV myocardial contractility after PEA was only revealed at peak exercise over time. Importantly, physical exercise capacity was significantly increased and was found to be directly correlated with improvement of resting and exercise‐induced RV‐EF.

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Associations of Exercise Tolerance With Hemodynamic Parameters for Pulmonary Arterial Hypertension and for Chronic Thromboembolic Pulmonary Hypertension

Abstract: PH etiology should be considered when assessing exercise tolerance, whereas CPET can be effective in addition to hemodynamic assessment by means of RHC for periodic evaluation during followup.

Cited by 10 publications

References 23 publications

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension　― Similar Effects on Health-Related Quality of Life ―

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension　― Similar Effects on Health-Related Quality of Life ―

Cardiopulmonary exercise test predicts right heart catheterization

Long‐term changes of resting and exercise right ventricular systolic performance in patients with chronic thromboembolic pulmonary hypertension following pulmonary thromboendarterectomy – A two‐dimensional and three‐dimensional echocardiographic study

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Associations of Exercise Tolerance With Hemodynamic Parameters for Pulmonary Arterial Hypertension and for Chronic Thromboembolic Pulmonary Hypertension

Abstract: PH etiology should be considered when assessing exercise tolerance, whereas CPET can be effective in addition to hemodynamic assessment by means of RHC for periodic evaluation during followup.

Cited by 10 publications

References 23 publications

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension ― Similar Effects on Health-Related Quality of Life ―

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension ― Similar Effects on Health-Related Quality of Life ―

Cardiopulmonary exercise test predicts right heart catheterization

Long‐term changes of resting and exercise right ventricular systolic performance in patients with chronic thromboembolic pulmonary hypertension following pulmonary thromboendarterectomy – A two‐dimensional and three‐dimensional echocardiographic study

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Resources

About

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension　― Similar Effects on Health-Related Quality of Life ―

Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension　― Similar Effects on Health-Related Quality of Life ―