Dynamic hyperinflation during exercise in patients with precapillary pulmonary hypertension

Respir Med. 2012 Feb;106(2):308-13. doi: 10.1016/j.rmed.2011.10.018. Epub 2011 Nov 18.

Abstract

Background: Patients with pulmonary arterial hypertension often present with a mild obstructive lung pattern, however, the functional consequences are not known.

Methods: We analysed flow volume loops during exercise in 61 patients with precapillary pulmonary hypertension (PH) (age 55 ± 14 years) in comparison with 21 patients with COPD (60 ± 12 years), 39 patients with pulmonary fibrosis (58 ± 11 years) and 38 healthy controls (HC) (39 ± 15 years). Inspiratory capacity (IC) was measured at rest, and during maximum exercise (max).

Results: HC exhibited a stable IC of 3.0 ± 0.9 l at rest, and at max. A reduction in IC of 2.6 ± 0.8 l at rest to 2.0 ± 0.7 l at max was observed in patients with COPD. Patients with PH exhibited a significant reduction in IC from 2.3 ± 0.6 l at rest to 2.1 ± 0.6 l at max, while patients with pulmonary fibrosis exhibited a stable IC of 1.8 ± 0.6 at rest and 1.7 ± 0.6 l at max. In patients with PH, a weak negative correlation was drawn between the change in IC (%) and peak VO2 (r = -0.29, p = 0.01), as well as with PVR (r = -0.27, p = 0.02).

Conclusion: Patients with PH demonstrate a characteristic change in IC during exercise, which might contribute to impaired exercise tolerance.

Publication types

  • Comparative Study

MeSH terms

  • Exercise Test*
  • Exercise Tolerance
  • Female
  • Forced Expiratory Volume
  • Humans
  • Hypertension, Pulmonary / physiopathology*
  • Hypertension, Pulmonary / rehabilitation
  • Inspiratory Capacity
  • Male
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / rehabilitation
  • Pulmonary Fibrosis / physiopathology*
  • Pulmonary Fibrosis / rehabilitation
  • Pulmonary Gas Exchange*
  • Pulmonary Ventilation*
  • Respiratory Function Tests
  • Rest