Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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Richter, MJ; Milger, K; Tello, K; Stille, P; Seeger, W; Mayer, E; Ghofrani, HA; Gall, H.
Heart rate response during 6-minute walking testing predicts outcome in operable chronic thromboembolic pulmonary hypertension.
BMC Pulm Med. 2016; 16(1): 96
Doi: 10.1186/s12890-016-0260-y
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- Milger-Kneidinger Katrin
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- Abstract:
- BACKGROUND: Six-minute walk test (6MWT) is routinely performed in chronic thromboembolic pulmonary hypertension (CTEPH) before pulmonary endarterectomy (PEA). However, the clinical relevance of heart rate response (ΔHR) and exercise-induced oxygen desaturation (EID) during 6MWT is remaining unknown. METHODS: Patients undergoing PEA in our center between 03/2013-04/2014 were assessed prospectively with hemodynamic and exercise parameters prior to and 1 year post-PEA. Patients with symptomatic chronic thromboembolic disease (mean pulmonary artery pressure (mPAP) <25 mmHg) and clinical relevant obstructive pulmonary disease were excluded. The following definitions were used: ΔHR = (peak HR - resting HR), percent heart rate reserve (HRR) = (peak HR -rest HR)/(220 - age - rest HR) x 100 and EID = SpO2 ≤88 %. RESULTS: Thirty-seven patients (of 116 patients screened) with mPAP of 43.2 ± 8.7 mmHg, pulmonary vascular resistance (PVR) of 605.5 ± 228.7 dyn*s/cm(5), cardiac index (CI) of 2.4 ± 0.5 l/min/m(2) and a 6MWT-distance of 404.7 ± 148.4 m and a peak VO2 of 12.3 ± 3.4 ml/min/kg prior to PEA were included. Baseline ΔHR during 6MWT was significantly associated with PVR 1 year post-PEA using linear regression analysis (r = 0.43, p = 0.01). Multivariate analysis indicated an association of HRR during 6MWT and residual PH with a hazard ratio of 1.06 (95 % Confidence interval for hazard ratio 0.99-1.14, p = 0.08). EID was observed commonly during 6MWT but no correlations to outcome parameters were found. CONCLUSIONS: This is the first prospective study to describe an association of ΔHR during 6MWT with pulmonary hemodynamics 1 year post-PEA. Our preliminary results indicate that HRR derived from 6MWT is of clinical significance. EID was commonly observed, albeit failed as a significant prognostic factor.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Arterial Pressure - administration & dosage
- Chronic Disease - administration & dosage
- Echocardiography - administration & dosage
- Endarterectomy - administration & dosage
- Female - administration & dosage
- Germany - administration & dosage
- Heart Rate - administration & dosage
- Humans - administration & dosage
- Hypertension, Pulmonary - physiopathology
- Linear Models - administration & dosage
- Logistic Models - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Multivariate Analysis - administration & dosage
- Oxygen Consumption - administration & dosage
- Prospective Studies - administration & dosage
- Pulmonary Artery - physiopathology
- Thromboembolism - complications, surgery
- Vascular Resistance - administration & dosage
- Walk Test - administration & dosage
- Find related publications in this database (Keywords)
- Oxygen desaturation
- Heart rate response
- Chronic thromboembolic pulmonary hypertension
- Pulmonary endarterectomy