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- Title
Comparison of change in end tidal carbon dioxide after three minutes of step exercise between systemic sclerosis patients with and without pulmonary hypertension.
- Authors
Bernstein, Elana J.; Gordon, Jessica K.; Spiera, Robert F.; Wei-Ti Huang; Horn, Evelyn M.; Mandl, Lisa A.
- Abstract
Objectives. Pulmonary hypertension (PH) is an important cause of morbidity and mortality in patients with SSc. The submaximal heart and pulmonary evaluation (step test) is a non-invasive, submaximal stress test that could be used to identify SSc patients with PH. Our aims were to determine whether change in end tidal carbon dioxide (...) from rest to end-exercise, and the minute ventilation to carbon dioxide production ratio (⋅VE/...), both as measured by the step test, differ between SSc patients with and without PH. We also examined differences in validated self-report questionnaires and potential PH biomarkers between SSc patients with and without PH. Methods. We performed a cross-sectional study of 27 patients with limited or dcSSc who underwent a right heart catheterization within 24 months prior to study entry. The study visit consisted of questionnaire completion; history; physical examination; step test performance; and phlebotomy. ..., ⋅VE/..., self-report data and biomarkers were compared between patients with and without PH. Results. SSc patients with PH had a statistically significantly lower median (interquartile range) APETCo2 than SSc patients without PH [-2.1 (-5.1 to 0.7) vs 1.2 (-0.7 to 5.4) mmHg, P = 0.035], and a statistically significantly higher median (interquartile range) ⋅VE/... [53.4 (39-64.1) vs 36.4 (31.9-41.1), P = 0.035]. There were no statistically significant differences in self-report data or biomarkers between groups. Conclusion. ... and ⋅VE... as measured by the step test are statistically significantly different between SSc patients with and without PH. ... and ⋅VE/... may be useful screening tools for PH in the SSc population.
- Subjects
PULMONARY hypertension diagnosis; RNA analysis; BIOMARKERS; CARBON dioxide; CARDIOPULMONARY system; CHI-squared test; COMPUTED tomography; EXERCISE tests; FISHER exact test; INTERLEUKINS; PEPTIDE hormones; PHLEBOTOMY; PHYSICAL diagnosis; POLYMERASE chain reaction; QUESTIONNAIRES; RESEARCH funding; RESPIRATORY measurements; SELF-evaluation; STATISTICS; SYSTEMIC scleroderma; DATA analysis; VASCULAR endothelial growth factors; CROSS-sectional method; REVERSE transcriptase polymerase chain reaction; DATA analysis software; DESCRIPTIVE statistics; MANN Whitney U Test; DISEASE complications
- Publication
Rheumatology, 2017, Vol 56, Issue 1, p87
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kew365