1. Distinguishing exercise intolerance in early‐stage pulmonary hypertension with invasive exercise hemodynamics: Rest VE/VCO2 and ETCO2 identify pulmonary vascular disease
- Author
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Raza, Farhan, Dharmavaram, Naga, Hess, Timothy, Dhingra, Ravi, Runo, James, Chybowski, Amy, Kozitza, Callyn, Batra, Supria, Horn, Evelyn M, Chesler, Naomi, and Eldridge, Marlowe
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Lung ,Clinical Research ,Carbon Dioxide ,Dyspnea ,Exercise Test ,Female ,Hemodynamics ,Humans ,Hypertension ,Pulmonary ,Male ,Oxygen Consumption ,cardiopulmonary exercise test ,ETCO2 ,invasive exercise hemodynamics ,pulmonary hypertension ,pulmonary vascular disease ,V-E/VCO2 ,VE/VCO2 ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology - Abstract
BackgroundAmong subjects with exercise intolerance and suspected early-stage pulmonary hypertension (PH), early identification of pulmonary vascular disease (PVD) with noninvasive methods is essential for prompt PH management.HypothesisRest gas exchange parameters (minute ventilation to carbon dioxide production ratio: VE /VCO2 and end-tidal carbon dioxide: ETCO2 ) can identify PVD in early-stage PH.MethodsWe conducted a retrospective review of 55 subjects with early-stage PH (per echocardiogram), undergoing invasive exercise hemodynamics with cardiopulmonary exercise test to distinguish exercise intolerance mechanisms. Based on the rest and exercise hemodynamics, three distinct phenotypes were defined: (1) PVD, (2) pulmonary venous hypertension, and (3) noncardiac dyspnea (no rest or exercise PH). For all tests, *p 40 mm Hg and rest ETCO2 40 mm Hg and ETCO2
- Published
- 2022