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Poster Presentations: Tuesday, November 2, 2010 |

Cardiac Bioimpedance During Exercise Testing in Patients With Idiopathic Pulmonary Arterial Hypertension FREE TO VIEW

Ralf H. Kaiser, MD; Christian Frantz, MD; Kerstin Haddasch; Robert Bals, PhD; Michael Böhm, PhD; Heinrike Wilkens, PhD
Author and Funding Information

Universityhospital des Saarlandes, Homburg/Saar, Germany



Chest. 2010;138(4_MeetingAbstracts):358A. doi:10.1378/chest.10765
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Abstract

PURPOSE: Idiopathic pulmonary arterial hypertension (IPAH) is a rare and exercise limiting disease. Therapy has focused on reduction of pulmonary vascular resistance. Right ventricular insufficiency develops due to pressure overload and is limiting survival of these patients. Furthermore left venricular function is reduced by chronic underfilling.Monitoring of haemodynamics has been done by ultrasound and invasively by right heart catheterisation. This may describe cardiac function only insufficient, as haemodynamics may change during exercise and balance between right and left ventricular function might change.

METHODS: Conventional spiroergometry testing was performed in 20 healthy volunteers and 21 patients with IPAH of various degree. In addition, measurements of cardiac performance were obtained using a BoMed NCOM cardiac bioimpedance instrument. 16 heart beats were averaged for every variable at baseline, unloaded paddeling, early exercise, anaerobic threshold and submaximal workload. Parameters were normalized by body surface area and are shown as mean±SD. P<0.05 was considered statistically significant.

RESULTS: Conventional spiroergometry testing was performed in 20 healthy volunteers and 21 patients with IPAH of various degree. In addition, measurements of cardiac performance were obtained using a BoMed NCOM cardiac bioimpedance instrument. 16 heart beats were averaged for every variable at baseline, unloaded paddeling, early exercise, anaerobic threshold and submaximal workload. Parameters were normalized by body surface area and are shown as mean±SD. P<0.05 was considered statistically significant.

CONCLUSION: In this study we were able to monitor non-invasively cardiac function of patients with IPAH during exercise. Tolerance to workload was reduced as well as stroke volume and cardiac index. The diminished filling is represented by reduced EDI, resulting in less increase of contractility as shown by reduced peak flow and ACI.

CLINICAL IMPLICATIONS: Our data reviews the haemodynamics in pulmonary arterial hypertension. Patients with IPAH were not able to compensate the lack of contractility by increasing heart rate, resulting in much lower cardiac output. We were able to show, that left ventricular underfilling affects cardiac performance during exercise, and additionally inotropic response is reduced in patients with IPAH.

DISCLOSURE: Ralf Kaiser, No Financial Disclosure Information; No Product/Research Disclosure Information

12:45 PM - 2:00 PM


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