To assess gas exchange and distribution of ventilation in Eisenmenger syndrome patients at rest and while performing submaximal exercise at an altitude of 2240 mts above sea level.
93 patients with Eisenmenger syndrome due to ASD 49p, VSD 27p, PDA 20p; 74 females, 19 males. Age 36±14(20-73)yo, height 1.53±0.1 m, weight 59±17 Kg. PAP 98±27 mmHg, PaO2 50±8 mmHg, V-A shunt QsQt% 14.9±5, Hb gr/dl 17.7±4.2. Gas exchange (GE) was assessed in 70 p at room air(ra),FiO2 1 (100%) and at the end of exercise (e). Independent student t test; p<0.05 * was considered as significative when compared to ra values also regression analysis with SPSS 10 was applied to data.
Spirometry; FEV1 mls. 1877±646; FEV1% 70±18, FEVI/FVC% 78±14, FEF% 56±30. GE is presented in table 1. A trend to decrease in PaO2 and pH was observed at the end of exercise although not statistically significant. Distribution of ventilation and gas exchange between rest r and submaximal exercise e (mets 1.60±0.5 to 3.45±1 )as follows :VE; Minute ventilation 10.2L±3.3 to 22L±7.2 *, AV Alveolar Ventilation 5.5L±1.9 to 12.8±4.4 *, VO2 mls/min; Oxygen consumption 230±64 to 514±130 *, VCO2mls/min; CO2 production 218±65 to 528±146 *.
Despite severe Pulmonary Arterial Hypertension and a significant right to left shunt, the change in paO2 during exercise is remarkable low even with a significant change in VO2. As it is also remarkable the preservation of pH and paCO2 with such an increase in VE and VA. We consider that the ventilatory pump may contribute significantly to the ability of these patients to perform exercise even in disadvantage conditions, as it is high altitude.
No limitation to perform regular activities and even light exertion could be recomended in this group of patients. More data is needed about the impact of long term exercise on the disease.
Edgar Bautista, None.