Sun X G, Hansen J E, Oudiz R J, Wasserman K
Department of Medicine, Harbor-UCLA Medical Center, Torrance, California, USA.
Circulation. 2001 Jul 24;104(4):429-35. doi: 10.1161/hc2901.093198.
Patients with primary pulmonary hypertension (PPH) have a pulmonary vasculopathy that leads to exercise intolerance due to dyspnea and fatigue. To better understand the basis of the exercise limitation in patients with PPH, cardiopulmonary exercise testing (CPET) with gas exchange measurements, New York Heart Association (NYHA) symptom class, and resting pulmonary hemodynamics were studied.
We retrospectively evaluated 53 PPH patients who had right heart catheterization and cycle ergometer CPET studies to maximum tolerance as part of their clinical workups. No adverse events occurred during CPET. Reductions in peak O(2) uptake (VO(2)), anaerobic threshold, peak O(2) pulse, rate of increase in VO(2), and ventilatory efficiency were consistently found. NYHA class correlated well with the above parameters of aerobic function and ventilatory efficiency but less well with resting pulmonary hemodynamics.
Patients with PPH can safely undergo noninvasive cycle ergometer CPET to their maximal tolerance. The CPET abnormalities were consistent and characteristic and correlated well with NYHA class.
原发性肺动脉高压（PPH）患者存在一种肺血管病变，可导致因呼吸困难和疲劳而出现运动不耐受。为了更好地理解PPH患者运动受限的基础，我们对进行了气体交换测量的心肺运动试验（CPET）、纽约心脏协会（NYHA）症状分级以及静息肺血流动力学进行了研究。
我们回顾性评估了53例PPH患者，这些患者作为临床检查的一部分接受了右心导管检查和极限运动耐量的蹬车CPET研究。CPET期间未发生不良事件。持续发现峰值摄氧量（VO₂）、无氧阈值、峰值氧脉搏、VO₂增加率和通气效率降低。NYHA分级与上述有氧功能和通气效率参数相关性良好，但与静息肺血流动力学相关性较差。
PPH患者能够安全地进行极限运动耐量的无创蹬车CPET。CPET异常具有一致性和特征性，且与NYHA分级相关性良好。
