Sex matters in pulmonary arterial hypertension

Naeije, Robert; D′Alto, Michele

doi:10.1183/09031936.00054514

Cited by 7 publications

(2 citation statements)

References 12 publications

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“…On the other hand, black African Americans compared with white Americans of European descent present with more severe disease and a poorer survival (3,7,15). If intrinsic differences in pulmonary vascular function matter to the prognosis of pulmonary vascular disease (19), one could hypothesize that black African Americans might have an intrinsically less distensible pulmonary circulation.…”

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confidence: 99%

Pulmonary vascular function and exercise capacity in black sub-Saharan Africans

Simaga

Vicenzi

Faoro

et al. 2015

Journal of Applied Physiology

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Sex and age affect the pulmonary circulation. Whether there may be racial differences in pulmonary vascular function is unknown. Thirty white European Caucasian subjects (15 women) and age and body-size matched 30 black sub-Saharan African subjects (15 women) underwent a cardiopulmonary exercise test and exercise stress echocardiography with measurements of pulmonary artery pressure (PAP) and cardiac output (CO). A pulmonary vascular distensibility coefficient α was mathematically determined from the natural curvilinearity of multipoint mean PAP (mPAP)-CO plots. Maximum oxygen uptake (V̇o2max) and workload were higher in the whites, while maximum respiratory exchange ratio and ventilatory equivalents for CO2 were the same. Pulmonary hemodynamics were not different at rest. Exercise was associated with a higher maximum total pulmonary vascular resistance, steeper mPAP-CO relationships, and lower α-coefficients in the blacks. These differences were entirely driven by higher slopes of mPAP-CO relationships (2.5 ± 0.7 vs. 1.4 ± 0.7 mmHg·l(-1)·min; P < 0.001) and lower α-coefficients (0.85 ± 0.33 vs. 1.35 ± 0.51%/mmHg; P < 0.01) in black men compared with white men. There were no differences in any of the hemodynamic variables between black and white women. In men only, the slopes of mPAP-CO relationships were inversely correlated to V̇o2max (P < 0.01). Thus the pulmonary circulation is intrinsically less distensible in black sub-Saharan African men compared with white Caucasian Europeans men, and this is associated with a lower exercise capacity. This study did not identify racial differences in pulmonary vascular function in women.

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confidence: 99%

Pulmonary vascular function and exercise capacity in black sub-Saharan Africans

Simaga

Vicenzi

Faoro

et al. 2015

Journal of Applied Physiology

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“…The most likely hypothesis is an ability to preserve an adapted RV function in women, explained by the protective role of estrogens (anti-remodeling effects). On the other hand, testosterone could have pro-remodeling effects [24].…”

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Exercise Hemodynamics in the Prognosis of Patients with Pulmonary Arterial Hypertension

Faure¹,

Valentin

Zysman

et al. 2020

Respiration

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Background: Assessment of prognosis is of major importance when deciding on a therapeutic strategy in patients with pulmonary arterial hypertension (PAH). Objectives: The aim of this study was to investigate the prognostic value of pulmonary hemodynamics during exercise and changes during treatment in patients with PAH. Methods: Consecutive incident patients (n = 49) with PAH undergoing right heart catheterization at rest and during a constant workload cycle exercise in supine position were included. Predictors of survival were identified at baseline using Cox proportional hazard regression models in a univariate analysis unadjusted and adjusted for age and gender. Results: During a median follow-up period of 42 months, 13 (27%) of the 49 patients studied died. Two predictors of death were found: rest-toexercise changes in heart rate and systolic pulmonary artery pressure. Adjusted hazard ratios were 0.92 (95% CI 0.86-0.99) and 0.93 (95% CI 0.88-0.99), respectively. These 2 variables were correlated with each other (r = 0.55, p < 0.001). Conclusions: Rest-to-exercise changes in heart rate and systolic pulmonary artery pressure measured at diagnosis are predictors of survival in patients with PAH. These measurements taken from an exercise test reflect right ventricular function.

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Physio-Metabolic Monitoring via Breath Employing Real-Time Mass Spectrometry: Importance, Challenges, Potentials, and Pitfalls

Sukul¹,

Trefz²

2022

Bioanalytical Reviews

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Sex matters in pulmonary arterial hypertension

Cited by 7 publications

References 12 publications

Pulmonary vascular function and exercise capacity in black sub-Saharan Africans

Pulmonary vascular function and exercise capacity in black sub-Saharan Africans

Exercise Hemodynamics in the Prognosis of Patients with Pulmonary Arterial Hypertension

Physio-Metabolic Monitoring via Breath Employing Real-Time Mass Spectrometry: Importance, Challenges, Potentials, and Pitfalls

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