RT Journal Article
SR Electronic
T1 Exercise right heart catheterisation in the diagnosis of pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3411
VO 42
IS Suppl 57
A1 Stephan Keusch
A1 Séverine Mueller-Mottet
A1 Anina Bucher
A1 Lars C. Huber
A1 Rudolf Speich
A1 Silvia Ulrich
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3411.abstract
AB Background: Exertional dyspnea is the hallmark of pulmonary hypertension (PH). We explored exercise RHC for suspected PH.Methods: RHC including supine maximal cycling exercise tests between April 2005 and November 2012 were reviewed. Hemodynamic at rest and exercise was compared with demographics, oxygenation, function, diagnosis, adverse events and survival.Results: RHC from 101 patients (70 women, age 61±14y) were analysed. At rest, 27 were diagnosed with precapillary PH (9 idiopathic, 7 scleroderma, 1 HIV, 6 chronic lung disease, 3 thromboembolic, 1 sarcoidosis) and 7 with post-capillary PH. Form the 67 patients (50 females) without resting PH, exercise precapillary PH was found in 13 patients (6 scleroderma, 1 HIV, 2 chronic lung disease, 4 thromboembolic and 1 sarcoidosis) and exercise postcapillary PH in 27 (17 scleroderma, 1 chronic lung disease, 1 sarcoidosis, 8 other diastolic dysfunction). Patients with resting precapillary PH had a significantly higher NT-pro-BNP, lower blood oxygenation and increase in mPAP with exercise compared to exercise precapillary PH. These differences were not found in postcapillary PH. The mean follow-up time was 934±682 days without any event –free survival difference between groups. Exercise RHCs were well tolerated without any adverse events during the examination.Conclusion: Different pulmonary hemodynamic profiles defined as normal, pre- or postcapillary PH with rest and exercise might be all found in diseases like scleroderma, sarcoidosis, chronic lung and thromboembolic diseases. Supine exercise RHC in the diagnostic algorithm of PH is save, however; the diagnostic contribution of exercise RHCs must be studied in prospective trials.