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Editorial |

Physiologic Markers of Exercise as a Potential Screening Tool for the Detection of Pulmonary Hypertension: “α” Few Steps Forward

Richa Agarwal, MD; Mardi Gomberg-Maitland, MD
Author and Funding Information

FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST the following: M. G.-M. reports that Actelion, Bayer, GeNo, Gilead, Medtronic, Novartis, Lung Biotechnology, and Reata, have provided funding to the University of Chicago during the last year to support her conduct of clinical trials; she has served as a consultant for Actelion, Bayer, Bellerophon (formerly known as Ikaria), GeNo, Gilead, Medtronic, and United Therapeutics as a member of steering committees and DSMB/event committees; she has received honoraria for CME from Medscape and ABComm; and she is a member of the PCORI Advisory Panel on Rare Diseases and a Special Government Employee for the FDA Cardio-Renal Division. None declared. (R. A.).

CORRESPONDENCE TO: Mardi Gomberg-Maitland, MD, Department of Medicine, Section of Cardiology, University of Chicago, 5841 S Maryland Ave, MC 5403, Chicago, IL 60637


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(2):295-297. doi:10.1016/j.chest.2015.08.024
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Extract

The normal pulmonary circulation is a high-flow and low-pressure circuit, capable of handling exercise-associated increases in cardiac output and transmural pressures through distension and recruitment of pulmonary capillaries, which in turn leads to decreased pulmonary vascular resistance. The distensible properties of the pulmonary capillaries represent an important advantage for the right ventricle (RV) during exercise, allowing it to operate with maximal efficiency and at lower energy consumption. If the field of pulmonary hypertension (PH) could identify when this vascular response to exercise becomes abnormal, we may have an advantage for tracking those subclinical, at-risk patients before the development of overt resting PH. The epidemiologic impact of early identification is sizeable when considering that severe delays in PH diagnosis and referral remain a problem in modern clinical practice and for population-derived registries.,,

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