HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Provencher, S. Articles by Simonneau, G. Search for Related Content PubMed PubMed Citation Articles by Provencher, S. Articles by Simonneau, G.

Heart rate responses during the 6-minute walk test in pulmonary arterial hypertension

¹ Centre des maladies vasculaires pulmonaires (UPRES EA 2705), Service de pneumologie et réanimation respiratoire, AP-HP-Université Paris Sud XI, Hôpital Antoine Béclère, Clamart, ² Service de physiologie, CHU de Bicêtre, Le Kremlin-Bicêtre, and ³ Centre chirurgical Marie-Lannelongue, Le Plessis-Robinson, France.

CORRESPONDENCE: S. Provencher, Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92140 Clamart, France. Fax: 33 146303824. E-mail: steeveprovencher{at}hotmail.com

Keywords: Exercise test, heart rate, pulmonary hypertension, stroke volume

Received: April 11, 2005
Accepted September 21, 2005

Patients with pulmonary arterial hypertension (PAH) exhibit a limited increase in stroke volume on exercise, and the heart rate (HR) increases may reflect the main mechanism that allows cardiac output to increase. The current prospective study documented the contribution of HR to the 6-min walking distance (6MWD) in idiopathic (IPAH) and nonidiopathic PAH.

Eighty-three patients (46 IPAH and 37 nonidiopathic PAH) underwent haemodynamic evaluation and a 6MWD test. Chronotropic response (peak walking HR minus resting HR) and peripheral oxygen saturation were monitored. Fifty-seven patients were also assessed after 5±2 months of treatment (bosentan n = 38, epoprostenol n = 14, bosentan-epoprostenol n = 3, iloprost n = 2).

Before treatment, the 6MWD was related to numerous demographic, haemodynamic and walking test characteristics. Stepwise regression analysis indicated that the only factors significantly associated with the 6MWD were stroke volume and chronotropic response in both IPAH and nonidiopathic PAH patients. Following treatment, changes in 6MWD were significantly related to changes in chronotropic response in both IPAH and nonidiopathic PAH.

In conclusion, baseline stroke volume and chronotropic response were independently associated with the 6-min walking distance in pulmonary arterial hypertension. The lack of chronotropic response may reflect the loss in normal physiological reserve in more unwell patients.

This article has been cited by other articles:

				H. J. Reesink, M. N. van der Plas, N. E. Verhey, R. P. van Steenwijk, J. J. Kloek, and P. Bresser Six-minute walk distance as parameter of functional outcome after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 510 - 516. [Abstract] [Full Text] [PDF]