TY - JOUR T1 - Cerebral tissue oxygenation in arterial and thromboembolic pulmonary hypertension JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2307 AU - Séverine Müller-Mottet AU - Florian F. Hildenbrand AU - Stephan Keusch AU - Marco Maggiorini AU - Rudolf Speich AU - Konrad E. Bloch AU - Silvia Ulrich Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2307.abstract N2 - Background: Arterial and thromboembolic pulmonary hypertension (PH) lead to hypoxemia.We hypothesised that PH-patients have an impaired cerebral tissue oxygenation (CTO) at rest and during exercise in comparison to healthy controls, and that CTO may be improved by inhalation of oxygen or nitric oxide.Methods: Patients undergoing right heart catheterization due to unexplained dyspnea were included. Pulmonary hemodynamics, blood oxygenation and CTO by near infrared spectroscopy were assessed after 10min of breathing room air, nitric oxide and oxygen, each randomized, cross-over, and during supine maximal bicycle exercise.Results: 16 patients with PH (mean pulmonary arterial pressure ≥25mmHg, 14 arterial, 2 chronic thromboembolic) and 15 unaffected controls were included. Exercise was associated with a lower CTO in PH patients (median 61%, quartiles57;64) compared with controls (67%,65;71, p=.013). Oxygen and nitric oxide inhalation led to a significant increase in CTO in PH. The 6minute walk distance significantly correlated with CTO (p=.000), and was the only predictor of CTO in a multivariate analysis including age, pulmonary vascular resistance and mixed venous oxygen saturation (adjusted R2.511, P<.001).Conclusion: CTO is decreased in PH vs. controls under even relatively mild exercise at 20 Watt. A lower CTO strongly correlates to a lower 6minute walk distance, even if corrected for age, blood oxygenation and hemodynamics. Supplemental oxygen and nitric oxide significantly improve CTO in PH.Clinicaltrials.gov: NCT01463514. ER -