Pulmonary Physiology: Pulmonary Physiology |

Correlation of Pulmonary Hemodynamics With Gas Exchange Parameters in Cardiopulmonary Exercise Testing in PAH FREE TO VIEW

Lucas Cruz, MD; Nausherwan Burki, MD; Raymond Foley, DO; Debapriya Datta, MD
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University of CT Health Center, Farmington, CT

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

Chest. 2016;150(4_S):1115A. doi:10.1016/j.chest.2016.08.1223
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SESSION TITLE: Pulmonary Physiology

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: In patients with Pulmonary Arterial Hypertension, (PAH), gas exchange abnormalities manifest as increased dead space [Vd/Vt]) during Cardiopulmonary Exercise Testing (CPExT). How gas exchange parameters during CPExT compare with mean pulmonary artery pressure (mean PAP) and pulmonary vascular resistance (PVR) in PAH has not been evaluated. The objective of this study was to determine if mean PAP and PVR correlate with gas exchange parameters (Vd/Vt and oxygen saturation) during CPExT in PAH.

METHODS: 6 patients with PAH (defined as mean PAP > 25mmHg and Pulmonary Capillary Wedge Pressure < 15), underwent CPExT at our facility. Patient demographics, mean PAP and PVR on right heart catheterization; oxygen uptake at maximal exercise (VO2max), Oxygen (O2) saturation at maximal exercise, Vd/Vt at rest and Vd/Vt with exercise during CPExT were noted. Correlation of mPAP and PVR respectively with Vd/Vt at rest and Vd/Vt with exercise and with oxygen saturation at maximal exercise was determined by using Pearson’s test for linear correlation. p < 0.05 was deemed statistically significant.

RESULTS: Mean age was 52.8 ± 5.9-years; 83% were females. Mean PAP was 53.8 ± 10 mm Hg; mean PVR was 808.6 ± 412 dynes/sec/ cm5. Mean VO2max = 56.3 ± 5.4%; mean Vd/Vt at rest = 0.28 ± 0.13; mean Vd/Vt with exercise = 0.17 ± 0.04; mean O2 saturation at maximal exercise=94 ± 2.3%. The correlation coefficient (r) between studied parameters and their statistical significance are shown below: Mean PAP vs. Vd/Vt at rest: r = 0.243 ; p = 0.6 Mean PAP vs. Vd/Vt with exercise: r = 0.24 ; p = 0.6 Mean PAP vs. O2 saturation: r = -0.193 ; p = 0.7 PVR vs. Vd/Vt at rest: r = -0.286 ; p = 0.3 PVR vs. Vd/Vt with exercise: r = 0.54 ; p = 0.6 PVR vs. O2 saturation: r = -0.38 ; p = 0.3.

CONCLUSIONS: In PAH patients, mean PAP and PVR did not have a significant correlation with Vd/Vt at rest, Vd/Vt with exercise and O2 saturation at maximal exercise.

CLINICAL IMPLICATIONS: Gas exchange parameters on CPExT may not indicate severity of PAH. Studies on a larger group of patients are needed to further validate these results.

DISCLOSURE: The following authors have nothing to disclose: Lucas Cruz, Nausherwan Burki, Raymond Foley, Debapriya Datta

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