@article {GroepenhoffP3931, author = {Herman Groepenhoff and Anton Vonk-Noordegraaf and Anco Boonstra and Nico Westerhof and Harm Jan Bogaard}, title = {Prognostic relevance of changes in exercise parameters in pulmonary arterial hypertension}, volume = {40}, number = {Suppl 56}, elocation-id = {P3931}, year = {2012}, publisher = {European Respiratory Society}, abstract = {Introduction: Exercise parameters measured at baseline predict survival in pulmonary arterial hypertension (PAH). However, it has not been determined whether changes in exercise parameters after follow up are useful to guide clinicians in their choices for (adjustment of) PAH treatment. The aim of this study was to determine changes in exercise variables after one year of PAH specific therapy and to relate these changes to subsequent survival.Methods: One year changes in cardiopulmonary exercise test variables and six minute walking distance (6MWD) were related to survival using Univariate Cox regression and Kaplan-Meier analysis in 40 PAH patients (mean age 44 {\textpm} 2 yrs).Results: After a mean follow up time of 81 ({\textpm} 5) months, two patients were scheduled for lung transplantation and 10 had died. Survival analysis showed that from all exercise variables only one-year changes in maximal oxygen uptake (VO2), VO2/ heart rate (O2pulse) and 6MWD were significant predictors of survival. Kaplan-Meier analysis (with ideal cut-off points estimated by receiver operating analysis) showed that patients with \> 5\% increase in VO2 or O2pulse had a significantly better cumulative survival (78 {\textpm} 12\% and 78 {\textpm} 10\%, respectively) compared to patients with \< 5\% increase in VO2 or O2pulse (cumulative survival 40 {\textpm} 13\% and 27 {\textpm} 20\%, respectively). Patients with \< 6\% decrease in 6MWD had a significantly better cumulative survival (84 {\textpm} 7\%) compared to patients with \> 6\% decrease in 6MWD (cumulative survival 25 {\textpm} 15\%).Conclusion: Changes in VO2, O2pulse and 6MWD from baseline to one year of follow up predict survival in PAH. Consequently, these variables could be considered to guide treatment in PAH patients.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/40/Suppl_56/P3931}, eprint = {https://erj.ersjournals.com/content/40/Suppl_56/P3931.full.pdf}, journal = {European Respiratory Journal} }