Right Ventricular Function in Patients With Severe COPD Evaluated for Lung Transplantation

Keller, Cesar A.; Ohar, Jill A.; Ruppel, Gregg; Wittry, Mark D.; Goodgold, Henry M.

doi:10.1378/chest.107.6.1510

Cited by 11 publications

(5 citation statements)

References 19 publications

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“…Many factors that trigger acute exacerbations typically increase ventilationperfusion ( _ V/ _ Q) mismatch and hypoxemia (37,38). This worsens pulmonary hypertension and produces right ventricular overload and, eventually, cor pulmonale (30,39). The development of cor pulmonale is a particularly ominous sign in COPD and is a major cause of mortality (40,41).…”

Section: Clinical Picturementioning

confidence: 99%

Acute Exacerbations and Respiratory Failure in Chronic Obstructive Pulmonary Disease

MacIntyre¹,

Huang²

2008

Proceedings of the American Thoracic Society

123

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Section: Clinical Picturementioning

confidence: 99%

Acute Exacerbations and Respiratory Failure in Chronic Obstructive Pulmonary Disease

MacIntyre¹,

Huang²

2008

Proceedings of the American Thoracic Society

123

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“…Methodological questions were addressed in exceptional cases only. Examples are as follows: the significant (p < 0.01) rise in RAP, PAPm and PAOP following leg elevation in the pedals (38); the kinetic analysis of pulmonary hemodynamics and oxygen uptake following a switch between light exercise (33 ± 6 watts, i.e., below the aerobic-anaerobic threshold) and a burst of more intense exercise (62 ± 10 watts) (70); the comparison of RVEF analysis by means of RHC and radionuclide ventriculography (64); studies of the variability of CO measurements by thermodilution (109); and investigations of the hemodynamic responses to various forms of exercise (isometric versus dynamic) (110,111).…”

Section: Methodological Aspectsmentioning

confidence: 99%

“…Thus, a weak but significant correlation was present between RVEF and cardiac index (r ¼ 0.36, p ¼ 0.03). Another study determined RVEF by two methods: radionuclide ventriculography and RHC (64). The results of both methods were significantly different (p < 0.001).…”

Section: Rv Function and Hemodynamicsmentioning

confidence: 99%

Right Heart Catheterization During Exercise in Patients with COPD—An Overview of Clinical Results and Methodological Aspects

Ewert

Heine

Bollmann

et al. 2018

COPD: Journal of Chronic Obstructive Pulmonary Disease

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While right heart catheterization (RHC) at rest is the gold standard to assess pulmonary hemodynamics in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH), the invasive measurement of exercise hemodynamics is less well established in this group. Since exercise hemodynamics are increasingly recognized as important clinical information in patients with PH, our goal was to review the literature in this field to provide a basis for clinical use, further studies, and future recommendations. We identified 69 studies (published since 1968) reporting RHC data in 2819 patients with COPD, of whom 2561 underwent exercise testing. Few studies simultaneously measured gas exchange during exercise. Overall, these studies showed large variations in the patient populations and research questions studied and the methods and definitions employed. Despite these limitations, the data consistently demonstrated the presence of precapillary PH at rest in up to 38% of patients with COPD. With exercise, a relevant proportion of patients developed an abnormal hemodynamic response, depending on the definition used. Furthermore, some studies assessed right ventricular function during exercise and showed a blunted increase in right ventricular ejection fraction. Drug effects and the impact of interventional procedures were also studied. Again, due to large variations in the patients studied and the methods used, firm conclusions are difficult to derive. Despite the limitations of this dataset, several recommendations with respect to technical aspects (body position, exercise protocol, and data acquisition) can be inferred for this challenging patient population and may be helpful for further studies or recommendations.

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“…In der Praxis viel häufiger wurde jedoch die Gasanalyse (insbesondere die VO 2 ) lediglich zur Bestimmung des HZV nach der FM genutzt [46][47][48][49][50][51][52][53]. Gelegentlich wurde während der Belastung eine stabile VCO 2 /VO 2 -Ratio genutzt, um dann im steady state die HZV-Messung nach der FM vorzunehmen [54].…”

Section: Entwicklung Der Icpetunclassified

Übersicht über die Entwicklung der invasiven Spiroergometrie (iCPET)

et al. 2021

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ZusammenfassungDie Standardmethode zur Messung der pulmonalen Hämodynamik ist der Rechtsherzkatheter (RHK) unter Ruhebedingungen, welcher international standardisiert ist. In den letzten Jahren wurden Bemühungen unternommen, auch die methodischen Aspekte des RHK unter Belastung zu vereinheitlichen und die somit gewonnenen Daten hinsichtlich ihrer prognostischen Aussagekraft zu definieren. Die Spiroergometrie als eine nichtinvasive Methode kann zusätzliche Aspekte der Pathophysiologie unter Belastung darstellen, und beide Methoden werden zunehmend kombiniert (als sog. invasive Spiroergometrie, iCPET) und ermöglichen eine sehr differenzierte Analyse der Belastungsreaktion.In dieser Übersicht werden die bisherigen Erfahrungen mit der invasiven Spiroergometrie dargestellt und insbesondere methodische Details erläutert.Die bisherigen Daten zur invasiven Spiroergometrie zeigen, dass diese komplexe Untersuchung besonders bei der Differenzierung der zugrundeliegenden Ursachen einer unklaren Dyspnoe hilfreich ist. Es zeichnet sich ab, dass über die Kombination aus hämodynamischen sowie ventilatorischen und gasanalytischen Daten schon frühe Formen einer kardialen bzw. pulmonalvaskulären Störung zu detektieren sind. Durch die zunehmende Validierung gewonnener Parameter aus der iCPET sind zukünftig Grenzwerte zur Unterscheidung normaler vs. pathologischer Belastungsreaktionen zu erwarten, die genauer als durch die alleinige Anwendung der jeweiligen Methoden möglich werden.

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Right Ventricular Function in Patients With Severe COPD Evaluated for Lung Transplantation

Cited by 11 publications

References 19 publications

Acute Exacerbations and Respiratory Failure in Chronic Obstructive Pulmonary Disease

Acute Exacerbations and Respiratory Failure in Chronic Obstructive Pulmonary Disease

Right Heart Catheterization During Exercise in Patients with COPD—An Overview of Clinical Results and Methodological Aspects

Übersicht über die Entwicklung der invasiven Spiroergometrie (iCPET)

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