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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 [OPEN ACCESS]
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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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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

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