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    Implications of Exercise-Induced Pulmonary Arterial Hypertension

    Access Status
    Open access via publisher
    Authors
    Fowler, R.
    Maiorana, Andrew
    Jenkins, Susan
    Gain, Kevin
    O'Driscoll, G.
    Gabbay, E.
    Date
    2011
    Type
    Journal Article
    
    Metadata
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    Citation
    Fowler, Robin M. and Maiorana, Andrew J. and Jenkins, Sue C. and Gain, Kevin R. and O'Driscoll, Gerry and Gabbay, Eli. 2011. Implications of Exercise-Induced Pulmonary Arterial Hypertension. Medicine & Science in Sports & Exercise. 43 (6): pp. 983-989.
    Source Title
    Medicine & Science in Sports & Exercise
    DOI
    10.1249/MSS.0b013e318204cdac
    ISSN
    0195-9131
    School
    School of Physiotherapy
    URI
    http://hdl.handle.net/20.500.11937/41052
    Collection
    • Curtin Research Publications
    Abstract

    Purpose: To characterize the hemodynamic and ventilatory responses to exercise in a group of patients with unexplained dyspnea, increased risk for pulmonary arterial hypertension (PAH), and an elevated mean pulmonary artery pressure (mPAP; >30 mm Hg) on exercise. Methods: A total of 37 symptomatic patients at risk of PAH and 20 healthy controls underwent a cardiopulmonary exercise test and were assessed for quality of life (QOL). Patients had a pulmonary artery catheter in situ during the exercise test. Results: Seventeen subjects had exercise-induced PAH (EIPAH), which we defined as mPAP ≤ 25 mm Hg at rest, and mPAP > 30 mm Hg and pulmonary artery wedge pressure <20 mm Hg on exercise. These subjects had reduced peak exercise cardiac output (72% ± 19% predicted). Further, compared with matched controls, subjects with EIPAH had reduced peak oxygen consumption (1.2 ± 0.4 vs 1.7 ± 0.5 L•min−1, P < 0.05), an elevated ventilatory equivalent for carbon dioxide (41.0 ± 7.3 vs 31.0 ± 2.9, P < 0.05) and reduced end-tidal carbon dioxide tension (32.6 ± 3.6 vs 39.4 ± 2.7 mm Hg, P < 0.05) at the anaerobic threshold. These exercise abnormalities were associated with impaired QOL (P < 0.05). Conclusions: Elevated pulmonary artery pressure on exercise can be associated with hemodynamic and ventilatory abnormalities typical of PAH, along with impaired exercise capacity and reduced QOL.

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