Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Kovacs, G; Maier, R; Aberer, E; Brodmann, M; Scheidl, S; Hesse, C; Troester, N; Salmhofer, W; Stauber, R; Fürst, F; Thonhofer, R; Ofner-Kopeinig, P; Gruenig, E; Olschewski, H.
Assessment of pulmonary arterial pressure during exercise in collagen vascular disease: echocardiography vs right-sided heart catheterization.
Chest. 2010; 138(2):270-278
Doi: 10.1378/chest.09-2099
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- Führende Autor*innen der Med Uni Graz
- Kovacs Gabor
- Co-Autor*innen der Med Uni Graz
- Aberer Elisabeth
- Brodmann Marianne
- Hesse Christian
- Maier Robert
- Moazedi-Fürst Florentine
- Ofner-Kopeinig Petra
- Olschewski Horst
- Salmhofer Wolfgang
- Scheidl Stefan
- Stauber Rudolf
- Tröster Natascha
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- Abstract:
- Background: This study compared the results of exercise Doppler echocardiography (EDE) with right-sided heart catheterization (RIIC) and evaluated the combination of EDE and cardiopulmonary exercise testing (CPET as a screening method for early pulmonary vasculopathy in patients with connective tissue disease. Methods: Patients (N = 52) with connective tissue disease (predominantly systemic sclerosis) and without known pulmonary arterial hypertension underwent both EDE and CPET. If systolic pulmonary arterial pressure (SPAP) was >40 mm Hg during exercise or peak oxygen uptake ((V)over dotO(2)) was <75% predicted, RHC was suggested. Results: EDE showed an SPAP >40 mm Hg during exercise in 26/52 patients. Additionally, CPET showed a peak (V)over dotO(2) < 75% predicted in 10/26 patients with SPAP <= 40 mm Hg upon exercise. Accordingly, RHC was suggested to 36 patients. RHC was performed in 28 of these patients, revealing SPAP >40 mm Hg in 25 patients (n = 1 at rest, n = 24 during exercise). SPAP values assessed by EDE showed no significant difference vs RHC at rest, 25 W, 50 W, and maximal exercise (difference [95% CI]: 0.3 [-2.7; 3.2], -1.3 [-7.1; 4.4], 0.9 [-7.7; 5.9], and -5.6 [-13.5; 2.2] mm Hg). Eight patients with exercise SPAP >40 mm Hg had an exercise pulmonary arterial wedge pressure > 20 mm Hg, suggesting exercise-induced left ventricular diastolic dysfunction not detectable by EDE. Conclusions: EDE appears to be a reasonable noninvasive method to detect SPAP increase during exercise in connective tissue disease. In combination with CPET, it may be a useful screening tool for early pulmonary vasculopathy, although RHC remains the gold standard for hemodynamic assessment.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Blood Pressure -
- Cardiac Catheterization -
- Connective Tissue Diseases - complications
- Echocardiography, Doppler -
- Exercise Test -
- Female -
- Humans -
- Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - etiology
- Male -
- Mass Screening -
- Middle Aged -
- Pulmonary Artery - physiopathology