Gabrielle Costa Borba1,2, Francini Porcher Andrade3,4,5, Tatiane de Souza Ferreira1,2, Antônio Fernando Furlan Pinotti2,6, Francisco Veríssimo Veronese2,7, Paula Maria Eidt Rovedder1,2,8,9. 1. Ciências Pneumológicas Post-Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ramiro Barcelos, 2400, 2º andar, Porto Alegre, RS, 90040-060, Brazil. 2. Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. 3. Ciências Pneumológicas Post-Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ramiro Barcelos, 2400, 2º andar, Porto Alegre, RS, 90040-060, Brazil. fran_porcher@hotmail.com. 4. Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. fran_porcher@hotmail.com. 5. Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal. fran_porcher@hotmail.com. 6. Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. 7. Division of Nephrology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. 8. Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal. 9. Physiotherapy School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Abstract
PURPOSE: To evaluate the estimated pulmonary arterial systolic pressure (PASP) through transthoracic echocardiography in hemodialysis (HD) patients and associate it with cardiorespiratory fitness and pulmonary function. METHODS: This study was a cross-sectional analysis of HD patients that performed evaluations of cardiac function, cardiorespiratory fitness, and pulmonary function, through transthoracic echocardiography, cardiopulmonary exercise test, spirometry, and manovacuometry, respectively. All patients underwent the evaluations on a non-dialysis day. RESULTS: Thirty-five HD patients were evaluated and separated according to the presence of probable pulmonary hypertension (PH) (estimated PASP ≥ 35 mmHg) or not (estimated PASP < 35 mmHg). Those HD patients with probable PH had the worst cardiorespiratory fitness, evaluated by the peak oxygen consumption (VO2peak) (17.11 ± 4.40 versus 12.90 ± 2.73 mL/kg/min; p = 0.011), and pulmonary function, evaluated by absolute and predicted of forced vital capacity (FVC) (85.52 ± 12.29 versus 71.38 ± 11.63%; p = 0.005) and absolute and predicted of forced expiratory volume in the first second (FEV1) (83.37 ± 14.98 versus 69.21 ± 13.48%; p = 0.017). The secondary analysis showed that estimated PASP was correlated with VO2peak (r = - 0.508; p = 0.002), FVC (r = - 0.450; p = 0.007), and FEV1 (r = - 0.361; p = 0.033). Moreover, the adjusted odds ratio by HD vintage, dry weight and gender showed that increments in VO2peak (OR 1.62; CI 95% 1.04-2.54; p = 0.034), FVC (OR 39.67; CI 95% 1.74-902.80; p = 0.021), and FEV1 (OR 39.54; CI 95% 1.89-826.99; p = 0.018) were associated with 1-fold and 39-fold higher chance, respectively, for not having PH. However, all these associations were lost when age was included in the analysis. CONCLUSIONS: The HD patients with probable PH had the worst cardiorespiratory fitness and pulmonary function. Exploratory analyses showed that greater cardiopulmonary fitness was associated with better cardiac function. Moreover, increments in cardiorespiratory fitness and pulmonary function may increase the chance of not having PH.
PURPOSE: To evaluate the estimated pulmonary arterial systolic pressure (PASP) through transthoracic echocardiography in hemodialysis (HD) patients and associate it with cardiorespiratory fitness and pulmonary function. METHODS: This study was a cross-sectional analysis of HD patients that performed evaluations of cardiac function, cardiorespiratory fitness, and pulmonary function, through transthoracic echocardiography, cardiopulmonary exercise test, spirometry, and manovacuometry, respectively. All patients underwent the evaluations on a non-dialysis day. RESULTS: Thirty-five HD patients were evaluated and separated according to the presence of probable pulmonary hypertension (PH) (estimated PASP ≥ 35 mmHg) or not (estimated PASP < 35 mmHg). Those HD patients with probable PH had the worst cardiorespiratory fitness, evaluated by the peak oxygen consumption (VO2peak) (17.11 ± 4.40 versus 12.90 ± 2.73 mL/kg/min; p = 0.011), and pulmonary function, evaluated by absolute and predicted of forced vital capacity (FVC) (85.52 ± 12.29 versus 71.38 ± 11.63%; p = 0.005) and absolute and predicted of forced expiratory volume in the first second (FEV1) (83.37 ± 14.98 versus 69.21 ± 13.48%; p = 0.017). The secondary analysis showed that estimated PASP was correlated with VO2peak (r = - 0.508; p = 0.002), FVC (r = - 0.450; p = 0.007), and FEV1 (r = - 0.361; p = 0.033). Moreover, the adjusted odds ratio by HD vintage, dry weight and gender showed that increments in VO2peak (OR 1.62; CI 95% 1.04-2.54; p = 0.034), FVC (OR 39.67; CI 95% 1.74-902.80; p = 0.021), and FEV1 (OR 39.54; CI 95% 1.89-826.99; p = 0.018) were associated with 1-fold and 39-fold higher chance, respectively, for not having PH. However, all these associations were lost when age was included in the analysis. CONCLUSIONS: The HD patients with probable PH had the worst cardiorespiratory fitness and pulmonary function. Exploratory analyses showed that greater cardiopulmonary fitness was associated with better cardiac function. Moreover, increments in cardiorespiratory fitness and pulmonary function may increase the chance of not having PH.
Authors: Ricardo de Carvalho Lima; Luis Fernando Kubrusly; Antonio Carlos de Sales Nery; Bruno Botelho Pinheiro; Alexandre Visconti Brick; Domingos Sávio Ramos de Souza; Domingos Marcolino Braile; Enio Buffolo; Fernando Antonio Lucchese; Frederico Pires de Vasconcelos Silva; João Nelson Branco; José Glauco Lobo Filho; José Teles de Mendonça; José Wanderley Neto; Jorge Augusto Nunes Guimarães; Marcius Vinícius M Maranhão; Maria do Socorro Duarte Leite; Mario Gesteira Costa; Maurílio Onofre Deininger; Mauro Barbosa Arruda; Mauro Arruda Filho; Mozart Augusto Soares de Escobar; Nilson Augusto Mendes Ribeiro; Paulo Slud Brofman; Pedro Rafael Salerno; Sérgio Tavares Montenegro; Jorge Ilha Guimarães Journal: Arq Bras Cardiol Date: 2004-04-23 Impact factor: 2.000
Authors: Mengyao Tang; Jonathan A Batty; Chiayu Lin; Xiaohong Fan; Kevin E Chan; Sahir Kalim Journal: Am J Kidney Dis Date: 2018-02-09 Impact factor: 8.860
Authors: P J Currie; J B Seward; K L Chan; D A Fyfe; D J Hagler; D D Mair; G S Reeder; R A Nishimura; A J Tajik Journal: J Am Coll Cardiol Date: 1985-10 Impact factor: 24.094
Authors: Süreyya Yılmaz; Yasar Yildirim; Zülfükar Yilmaz; Ali Veysel Kara; Mahsuk Taylan; Melike Demir; Mehmet Coskunsel; Ali Kemal Kadiroglu; Mehmet Emin Yilmaz Journal: Med Sci Monit Date: 2016-08-07