Yi Tang1, Lei Yao2, Zhihong Liu3, Wenlin Xie4, Xiuping Ma1, Qin Luo1, Zhihui Zhao1, Zhiwei Huang1, Liu Gao1, Qi Jin1, Xue Yu1, Changming Xiong1, Xinhai Ni1, Yinkun Yan5, Wenwei Qi6. 1. Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Department of Cardiology, People's Hospital of Shouguang City, Shandong, China. 3. Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: zhihongliufuwai@163.com. 4. Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China. 5. Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China. 6. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
Abstract
BACKGROUND: Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hypertension (IPAH). METHODS: Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation). RESULTS: One hundred forty patients with IPAH (104 female, mean age: 33 ± 11 years) were studied. During follow-up (mean: 42 ± 14 months), 24 patients died and 1 patient underwent lung transplantation. In the univariate analysis, peak oxygen uptake(VO2), oxygen uptake at anaerobic threshold, ventilation (VE)/carbon dioxide output (VCO2) slope, end-tidal partial pressure of carbon dioxide at anaerobic threshold, peak systolic blood pressure (SBP), the change of SBP, the change of heart rate, peak work rate, peak CircP, pulmonary vascular resistance, cardiac index and World Health Organization functional class were predictive of cardiac events (all P < .05).In the multivariate analysis, Peak CircP in the fourth model had the highest significance compared with peak VO2 and VE/VCO2 slope in the second and third model (chi-square = 5.26, P < .02, HR: 0.99, 95% CI: 0.99 to 1.00). CONCLUSIONS: Peak CircP, better than peak VO2 and VE/VCO2slope, was a strong predictor of cardiac events among exercise parameters in patients with IPAH.
BACKGROUND: Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hypertension (IPAH). METHODS:Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation). RESULTS: One hundred forty patients with IPAH (104 female, mean age: 33 ± 11 years) were studied. During follow-up (mean: 42 ± 14 months), 24 patients died and 1 patient underwent lung transplantation. In the univariate analysis, peak oxygen uptake(VO2), oxygen uptake at anaerobic threshold, ventilation (VE)/carbon dioxide output (VCO2) slope, end-tidal partial pressure of carbon dioxide at anaerobic threshold, peak systolic blood pressure (SBP), the change of SBP, the change of heart rate, peak work rate, peak CircP, pulmonary vascular resistance, cardiac index and World Health Organization functional class were predictive of cardiac events (all P < .05).In the multivariate analysis, Peak CircP in the fourth model had the highest significance compared with peak VO2 and VE/VCO2 slope in the second and third model (chi-square = 5.26, P < .02, HR: 0.99, 95% CI: 0.99 to 1.00). CONCLUSIONS: Peak CircP, better than peak VO2 and VE/VCO2slope, was a strong predictor of cardiac events among exercise parameters in patients with IPAH.
Authors: Pim Knuiman; Sam Straw; John Gierula; Aaron Koshy; Lee D Roberts; Klaus K Witte; Carrie Ferguson; Thomas Scott Bowen Journal: ESC Heart Fail Date: 2021-02-20
Authors: Katarina Zeder; Chiara Banfi; Gregor Steinrisser-Allex; Bradley A Maron; Marc Humbert; Gregory D Lewis; Andrea Berghold; Horst Olschewski; Gabor Kovacs Journal: Eur Respir J Date: 2022-10-13 Impact factor: 33.795