Article
Borderline pulmonary hypertension was associated with reduced cardiac output during exercise in patients with connective tissue diseases
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Published: | February 5, 2019 |
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Outline
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Background: In patients with systemic sclerosis (SSc) borderline mean pulmonary arterial pressures (mPAP; 21-24 mmHg at rest) are a frequent finding and could represent an intermediate stage between normal pulmonary pressuresand manifest pulmonary hypertension (PH) [1].
The objective of this prospective study was to compare right ventricular function and pulmonary arterial compliance (PAC) at rest and during exercise between systemic sclerosis (SSc)-patients with normal and borderline mean pulmonary artery pressures, respectively.
Methods: SSc-patients (n=112) underwent clinical assessment. including right heart catheterization at rest and during exercise and were divided in three groups according to their resting mPAP values: normal mPAP (≤20 mmHg), borderline mPAP (21-24 mmHg) and manifest pulmonary hypertension (PH, mPAP ≥25 mmHg). Results were compared between groups by ANOVA followed by post-hoc student’s t-test.
Results: SSc Patients with borderline PAP showed significantly lower cardiac index (CI) increase during exercise and higher PVR values than SSc patients with normal PAP at rest. Six-Minute-walking distance (6MWD) and PAC (strokevolume/(systolicPAP-diastolicPAP) were significantly lower in the borderline PAP group compared to patients with normal PAP.
Conclusion: These findings indicate that right ventricular dysfunction during exercise might be an early stage of pulmonary hypertension leading to impaired exercise capacity in patients with connective tissue diseases.