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- Title
Evaluation of end-tidal CO pressure at the anaerobic threshold for detecting and assessing pulmonary hypertension.
- Authors
Higashi, Akifumi; Dohi, Yoshihiro; Yamabe, Sayuri; Kinoshita, Hiroki; Sada, Yoshiharu; Kitagawa, Toshiro; Hidaka, Takayuki; Kurisu, Satoshi; Yamamoto, Hideya; Yasunobu, Yuji; Kihara, Yasuki
- Abstract
Cardiopulmonary exercise testing (CPET) is useful for the evaluation of patients with suspected or confirmed pulmonary hypertension (PH). End-tidal carbon dioxide pressure (PETCO) during exercise is reduced with elevated pulmonary artery pressure. However, the utility of ventilatory parameters such as CPET for detecting PH remains unclear. We conducted a review in 155 patients who underwent right heart catheterization and CPET. Fifty-nine patients had PH [mean pulmonary arterial pressure (mPAP) ≥25 mmHg]. There was an inverse correlation between PETCO at the anaerobic threshold (AT) and mPAP ( r = −0.66; P < 0.01). Multiple regression analysis showed that PETCO at the AT was independently associated with an elevated mPAP ( P = 0.04). The sensitivity and specificity of CPET for PH were 80 and 86%, respectively, when the cut-off value identified by receiver operating characteristic curve analysis for PETCO at the AT was ≤34.7 mmHg. A combination of echocardiography and CPET improved the sensitivity in detecting PH without markedly reducing specificity (sensitivity 87%, specificity 85%). Evaluation of PETCO at the AT is useful for estimating pulmonary pressure. A combination of CPET and previous screening algorithms for PH may enhance the diagnostic ability of PH.
- Subjects
PULMONARY hypertension; PULMONARY circulation; EISENMENGER syndrome; ECHOCARDIOGRAPHY; MULTIPLE regression analysis; CATHETERIZATION; BLOOD pressure
- Publication
Heart & Vessels, 2017, Vol 32, Issue 11, p1350
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-017-0999-y