RT Journal Article
SR Electronic
T1 Acute hyperoxic challenge improves haemodynamics & Pulmonary vascular stiffness in interstitial lung disease-associated pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4889
DO 10.1183/13993003.congress-2016.PA4889
VO 48
IS suppl 60
A1 Peter George
A1 Tristan Huie
A1 Jeff Swigris
A1 Kern Buckner
A1 Kevin Brown
A1 Brett Fenster
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA4889.abstract
AB Introduction: Pulmonary hypertension (PH) is a potentially severe complication of interstitial lung disease (ILD) that results from multiple mechanisms, including hypoxic pulmonary vasoconstriction. Because hyperoxia may have vasodilatory effects, we tested whether acute hyperoxia improved hemodynamics and pulmonary vascular stiffness in an ILD-PH cohort.Methods: Patients with ILD and suspected PH underwent right heart catheterization (RHC). Patients with low peripheral oxygen saturation (SpO2) were administered supplemental O2 to achieve an SpO2 ≥ 90% and then haemodynamic data were collected. Hemodynamics were repeated after 100% FiO2 for 5 minutes.Results: The cohort comprised 23 patients with ILD and RHC-proven PH (mean pulmonary artery pressure (mPAP) 33±7.34 mmHg, pulmonary artery occlusion pressure 12±2.5 mmHg, pulmonary vascular resistance (PVR) 4.9±2.8 Wood's Units (WU), and capacitance 2.07±0.89 mL/mmHg. 11 patients required supplemental oxygen to achieve an SpO2>90% The baseline mean SpO2 was 94.4%; 3 patients were hypoxic (PaO2<8kPa). 100% FiO2 improved SpO2 (+4.1%), reduced mPAP (-2.7±4.3 mmHg, p=0.002), PVR (-0.78±1.24 WU, p=0.0007), and pulmonary vascular stiffness (increased capacitance) (+0.39±0.48 mmHg/mL, p<0.0001).Discussion: Hyperoxia acutely improves hemodynamics and vascular stiffness even in the absence of hypoxaemia, suggesting oxygen supplementation may be beneficial in normoxic ILD PH. Because proximal pulmonary arterial remodeling contributes significantly to overall vascular stiffness, these acute changes in stiffness with hyperoxia suggest previously undescribed improvements in proximal arterial mechanics.