RT Journal Article
SR Electronic
T1 Oxygen desaturation on the six-minute walk test and mortality in untreated primary pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 647
OP 652
DO 10.1183/09031936.01.17406470
VO 17
IS 4
A1 G. Paciocco
A1 F.J. Martinez
A1 E. Bossone
A1 E. Pielsticker
A1 B. Gillespie
A1 M. Rubenfire
YR 2001
UL http://erj.ersjournals.com/content/17/4/647.abstract
AB There are no reliable predictors of mortality in primary pulmonary hypertension (PPH). This study assessed whether exercise oxygen desaturation and distance achieved during a six-minute walk are associated with mortality in moderately symptomatic patients with PPH.Thirty-four patients with PPH underwent a pretreatment six-minute walk test, and an invasive haemodynamic assessment of pulmonary vasodilator reserve, to select the best treatment option (epoprostenol in 27 and nifedipine in 7). Median follow-up was 26 months (12 months for the nonsurvivors was 26%), and median survival, >46 months by Kaplan-Maier estimate.The mean±sd distance walked was 275±155 m and reduction in arterial oxygen saturation (Sa,O2) at maximal distance (ΔSa,O2) was 8.4±4.5%. A distance ≤300 m increased mortality risk by 2.4, and a ΔSa,O2 of ≥10 % increased mortality risk by 2.9. Only Sa,O2 at peak distance, ΔSa,O2 and pulmonary vascular resistance (PVR) were related to mortality. After adjusting for PVR, there remained a 27% increase in risk of death for each per cent decrease in Sa,O2.The six-minute walk distance and exercise oxygen saturation may be helpful in selecting patients with primary pulmonary hypertension for whom transplant listing is appropriate.