Exercise oxygen uptake efficiency slope independently predicts poor outcome in pulmonary arterial hypertension

Ramos, Roberta Pulcheri; Ota-­Arakaki, Jaquelina Sonoe; Alencar, Maria Clara; Nery, Luíz Eduardo; Neder, J. Alberto

doi:10.1183/09031936.00167713

Cited by 19 publications

(25 citation statements)

References 12 publications

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“…9,[10][11][12][13][14][15] Recently, a few studies reported on the OUES as a prognostic marker in patients with cardiopulmonary diseases. [16][17][18][19][20][21] A more established exercise parameter to predict prognosis is the VE/VCO 2 slope, which represents the linear regression relation of VE and carbon dioxide production (VCO 2 ). 22 It is a measure of ventilatory efficiency that has been shown to be related to morbidity and mortality in various groups of patients, such as patients with chronic heart failure (CHF), congenital heart disease, chest pain suspected to be CAD and respiratory disease.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of the oxygen uptake efficiency slope and other exercise variables in patients with coronary artery disease

Coeckelberghs

Buys

Goetschalckx

et al. 2015

Eur J Prev Cardiolog

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The oxygen uptake efficiency slope is an independent predictor for all-cause and cardiovascular mortality in patients with coronary artery disease, irrespective of a truly maximal effort during cardiopulmonary exercise tests. Furthermore, the oxygen uptake efficiency slope provides prognostic information, complementary to the minute ventilation/carbon dioxide production slope and peak exercise capacity.

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Section: Introductionmentioning

confidence: 99%

Prognostic value of the oxygen uptake efficiency slope and other exercise variables in patients with coronary artery disease

Coeckelberghs

Buys

Goetschalckx

et al. 2015

Eur J Prev Cardiolog

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“…The units L/min/log(L/min) [25][26][27][28][29][30][31] , L/min/logL [32][33][34][35] and L/ min/logVE 36) are not logical, because logarithm is not included in the unit.…”

Section: The Unit Of Ouesmentioning

confidence: 99%

“…The OUES has been applied to evaluate cardiorespiratory fitness in patients with various diseases as well as in healthy individuals 1,3,4,9,11,15,17, [24][25][26][32][33][34][35]37,44) ; these various diseases include heart diseases 1,4,6,8,9,12-16,18, 21,28,29,33,38,[40][41][42][43][44]46) , orthopedic surgery 5) , gastroenterological surgery 7) , intellectually disabled young people 10) , multiple sclerosis 17, 23,33,39,45) , chronic obstructive pulmonary disease 15,27,33,45) , pulmonary arterial hypertension 19,20,30,36) , lung cancer 22) , severely overweight people 31,32) and cystic fibrosis 34,35) . Despite the high concern regarding the value of OUES, its unit is still unsettled.…”

Section: Introductionmentioning

confidence: 99%

Unit of oxygen uptake efficiency slope

Uchida

2018

JPFSM

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The oxygen uptake efficiency slope (OUES) is the slope of a regression line of oxygen uptake (VO 2 ) on logarithmically converted minute ventilation (V E ) measured during incremental exercise: VO 2 = alog 10 V E + b. Here, a is the OUES. The higher the OUES, the more efficient the uptake of oxygen. The OUES has been widely accepted to estimate maximum oxygen uptake without maximal exercise. Nevertheless, the unit of OUES is unsettled in the literature having eight different descriptions. We introduced a new equation for the OUES using resting VO 2 (VO 2 rest ) and resting V E (V E rest ): VO 2 = alog 10 (V E /V E rest ) + VO 2 rest . This equation is based on the mathematical principle that an antilogarithm such as V E /V E rest is dimensionless. It is clear from this equation that OUES has the same unit as VO 2 , because log 10 (V E /V E rest ) is just a numerical value without the unit. The new equation is written as VO 2 = alog 10 V E -alog 10 V E rest + VO 2 rest , where b = -alog 10 V E rest + VO 2 rest . The OUES value is obtained from Baba's original equation with VO 2 and V E during incremental exercise. The new equation is useful to identify the unit of OUES and the y-intercept b.

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“…It can be used as an estimate of peak VO 2 which requires only submaximal effort [121,122]. It has recently been shown to be of prognostic value in PAH [123].…”

Section: Cardiopulmonary Exercise Testingmentioning

confidence: 99%

The Role of Exercise Testing in the Modern Management of Pulmonary Arterial Hypertension

Johnson

Thomson

2014

Diseases

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A culture of exercise testing is firmly embedded in the management of pulmonary arterial hypertension (PAH) but its clinical relevance and utility have recently been under some debate. The six minute walk test (6MWT) has been used as a primary outcome measure to enable the licensing of many of the medications used for this condition. Recent reviews have questioned the validity of this test as a surrogate of clinical outcomes. At the same time, other questions are emerging where exercise testing may be the solution. With the rise in understanding of genetic markers of idiopathic PAH (IPAH), the screening of an otherwise healthy population for incipient pulmonary hypertension (PH) will be required. The proliferation in treatment choices and identification of populations with PH where PAH treatment is not indicated, such as left heart and lung disease, requires more definitive differentiation from patients with PAH. There is a continuing question about the existence and clinical relevance of exercise induced PAH as a cause of unexplained dyspnoea and fatigue and as a latent phase of resting PH. This review presents a summary and critical analysis of the current role of exercise testing in PAH and speculates on future trends.

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Exercise oxygen uptake efficiency slope independently predicts poor outcome in pulmonary arterial hypertension

Abstract: 7Borghi-Silva A, Carrascosa C, Oliveira CC, et al. Effects of respiratory muscle unloading on leg muscle oxygenation and blood volume during high-intensity exercise in chronic heart failure.

Cited by 19 publications

References 12 publications

Prognostic value of the oxygen uptake efficiency slope and other exercise variables in patients with coronary artery disease

Prognostic value of the oxygen uptake efficiency slope and other exercise variables in patients with coronary artery disease

Unit of oxygen uptake efficiency slope

The Role of Exercise Testing in the Modern Management of Pulmonary Arterial Hypertension

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