Role of pulmonary hemodynamics in determining 6-minute walk test result in atrial septal defect: an observational study

Supomo, Supomo; Darmawan, Handy; Arjana, Adika Zhulhi

doi:10.1186/s13019-018-0725-6

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…15 While noninvasive correlates may guide our understanding of exertional intolerance, measuring hemodynamics directly with a pulmonary artery catheter remains the gold standard in the assessment of pulmonary hypertension and can be used to explain the mechanisms underlying a decreased 6MWD. 16 Potential causes of a decreased 6MWD include decreased oxygen delivery (DO 2 ) and its utilization. Other groups have shown correlations between a decreased 6MWD and invasive hemodynamics, but none has done so concurrently.…”

Section: Introductionmentioning

confidence: 99%

Fick principle and exercise pulmonary hemodynamic determinants of the six‐minute walk distance in pulmonary hypertension

et al. 2020

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The six-minute walk test is widely used to assess the severity and prognosis of pulmonary hypertension. However, the pathophysiology underlying a compromised six-minute walk distance is incompletely characterized. The purpose of this study is to evaluate the Fick principle and pulmonary hemodynamic determinants of the six-minute walk distance in patients with suspected pulmonary hypertension. Twenty-nine patients were retrospectively studied and underwent a right heart catheterization for the evaluation of suspected pulmonary hypertension. With the pulmonary artery catheter in place, patients were moved to a treadmill and completed a six-minute walk test. Fick cardiac output and indices of right heart afterload were calculated using continuous measurements of pulmonary vascular pressures, gas exchange, and mixed venous blood samples. Fifteen subjects who walked ≤ 348 m were compared to 14 subjects who walked > 348 m. Systemic oxygen delivery was impaired in six-minute walk distance ≤ 348 m compared to six-minute walk distance > 348 m (15.2 ± 6.2 vs. 23.2 ± 6.8 mL/kg/min, p < 0.01). Impaired oxygen delivery was due to a depressed cardiac index and decreased cardiac reserve demonstrated by the change in the stroke volume index (3.0 ± 14 vs. 17 ± 15 mL/min/m2, p = 0.02). The six-minute walk distance positively correlated with oxygen delivery ( r = 0.501, p = 0.006) and inversely correlated with oxygen extraction ( r = 0.369, p = 0.049). A decreased six-minute walk distance was associated with an increased total pulmonary resistance ( r = 0.502, p = 0.006) and pulmonary vascular resistance ( r = 0.530, p = 0.003). In patients with suspected pulmonary hypertension, a decreased six-minute walk distance is due to compromised oxygen delivery, decreased cardiac reserve, and increased right ventricular afterload.

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Section: Introductionmentioning

confidence: 99%

Fick principle and exercise pulmonary hemodynamic determinants of the six‐minute walk distance in pulmonary hypertension

et al. 2020

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“…No correlation was found between the change in distance compared to the baseline study and the risk of the endpoint. However, a number of studies have indicated that improvements found in the 6MWT were paralleled by improvements in hemodynamic parameters assessed at the time of right heart catheterization [ 34 ]. The 6MWT is undoubtedly a very useful yet simple test to assess and compare exercise tolerance in patients undergoing targeted treatment for PAH.…”

Section: Discussionmentioning

confidence: 99%

Tricuspid Regurgitation Velocity/Tricuspid Annular Plane Systolic Excursion (TRV/TAPSE) Ratio as a Novel Indicator of Disease Severity and Prognosis in Patients with Precapillary Pulmonary Hypertension

Topyła-Putowska,

Tomaszewski,

Wojtkowska

et al. 2023

Diseases

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Background: Tricuspid annular plane systolic excursion (TAPSE) and tricuspid regurgitation velocity (TRV) are two echocardiographic parameters with prognostic value in patients with pulmonary hypertension (PH). When analyzed concurrently as the TRV/TAPSE ratio, they allow the ventricular–pulmonary artery coupling (RVPAC) to be assessed. This could better predict disease severity in patients with PH. Objective: Our study aimed to evaluate the prognostic value of the TRV/TAPSE ratio echocardiographic parameter in adults with precapillary PH. Methods: This study included 39 patients (74% women; average age, 63 years) with precapillary PH (pulmonary arterial hypertension and chronic thromboembolic PH) The mean follow-up period was 16.6 ± 13.3 months. Twelve patients (31%) died during the observation time. We measured TAPSE as a surrogate of RV contractility and TRV reflecting RV afterload, while ventricular–arterial coupling was evaluated by the ratio between these two parameters (TRV/TAPSE). To assess disease progression and the patient’s functional capacity, the World Health Organization functional class (WHO FC) was determined. Patient physical capacity was also evaluated using the 6 min walk test (6MWT). The analysis included values of N-terminal prohormone brain natriuretic peptide (NT-proBNP), which were taken routinely during the follow-up visit. Results: The mean calculated TRV/TAPSE ratio was 0.26 ± 0.08 m/s/mm. Upon comparison of the TRV/TAPSE ratio to the disease prognostic indicators, we observed a statistically significant correlation between TRV/TAPSE and the results of the WHO FC, 6MWT, and NT-proBNP. The TRV/TAPSE ratio is thus a good predictor of mortality in PH patients (AUC, 0.781). Patients with a TRV/TAPSE ratio > 0.30 m/s/mm had a shorter survival time, with log-rank test p < 0.0001. Additionally, ROC analysis revealed higher AUC for TRV/TAPSE than for TAPSE and TRV alone. Conclusions: TRV/TAPSE is a promising practicable echocardiographic parameter reflecting RVPAC. Moreover, TRV/TAPSE could be viable risk stratification parameter and could have prognostic value in patients with PH.

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“…La comunicación interauricular (CIA) se presenta en 1.64 por 1,000 nacidos vivos y representa casi 10% de todas las cardiopatías congénitas 1 , 2 . Los adultos con CIA son casi siempre asintomáticos o señalan leve intolerancia a los esfuerzos, aunque puede demostrarse reducción de la función cardiopulmonar en ejercicio 3 .…”

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Hipoxemia inducida por el ejercicio en una paciente adulta con comunicación interauricular

Vergara-Uzcategui¹,

Salinas²,

Nombela‐Franco³

2021

ACM

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Role of pulmonary hemodynamics in determining 6-minute walk test result in atrial septal defect: an observational study

Cited by 3 publications

References 14 publications

Fick principle and exercise pulmonary hemodynamic determinants of the six‐minute walk distance in pulmonary hypertension

Fick principle and exercise pulmonary hemodynamic determinants of the six‐minute walk distance in pulmonary hypertension

Tricuspid Regurgitation Velocity/Tricuspid Annular Plane Systolic Excursion (TRV/TAPSE) Ratio as a Novel Indicator of Disease Severity and Prognosis in Patients with Precapillary Pulmonary Hypertension

Hipoxemia inducida por el ejercicio en una paciente adulta con comunicación interauricular

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