Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases
The early diagnosis of pulmonary arterial hypertension (PAH) is a major determinant of prognosis in patients affected by connective tissue diseases (CTDs) complicated by PAH. In the present paper we investigated the diagnostic accuracy of cardiopulmonary exercise testing (CPET) in this specific sett...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/14/4/342 |
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| author | Mattia Bellan Ailia Giubertoni Cristina Piccinino Mariachiara Buffa Debora Cromi Daniele Sola Roberta Pedrazzoli Ileana Gagliardi Elisa Calzaducca Erika Zecca Filippo Patrucco Giuseppe Patti Pier Paolo Sainaghi Mario Pirisi |
| author_facet | Mattia Bellan Ailia Giubertoni Cristina Piccinino Mariachiara Buffa Debora Cromi Daniele Sola Roberta Pedrazzoli Ileana Gagliardi Elisa Calzaducca Erika Zecca Filippo Patrucco Giuseppe Patti Pier Paolo Sainaghi Mario Pirisi |
| author_sort | Mattia Bellan |
| collection | DOAJ |
| description | The early diagnosis of pulmonary arterial hypertension (PAH) is a major determinant of prognosis in patients affected by connective tissue diseases (CTDs) complicated by PAH. In the present paper we investigated the diagnostic accuracy of cardiopulmonary exercise testing (CPET) in this specific setting. We recorded clinical and laboratory data of 131 patients who underwent a CPET at a pulmonary hypertension clinic. Out of them, 112 (85.5%) had a diagnosis of CTDs; 8 (6.1%) received a diagnosis of CTDs-PAH and 11 (8.4%) were affected PH of different etiology. Among CPET parameters the following parameters showed the best diagnostic performance for PAH: peak volume of oxygen uptake (VO<sub>2</sub>; AUC: 0.845, CI95% 0.767–0.904), ratio between ventilation and volume of exhaled carbon dioxide (VE/VCO<sub>2</sub> slope; AUC: 0.888, CI95%: 0.817–0.938) and end-tidal partial pressures (PetCO<sub>2</sub>; AUC: 0.792, CI95%: 0.709–0.861). These parameters were comparable among CTDs-PAH and PH of different etiology. The diagnostic performance was even improved by creating a composite score which included all the three parameters identified. In conclusion, CPET is a very promising tool for the stratification of risk of PAH among CTDs patients; the use of composite measures may improve diagnostic performance. |
| first_indexed | 2024-03-10T12:29:33Z |
| format | Article |
| id | doaj.art-01d06c8ce19a4681925a3d5fdd7f1f92 |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-10T12:29:33Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-01d06c8ce19a4681925a3d5fdd7f1f922023-11-21T14:42:55ZengMDPI AGPharmaceuticals1424-82472021-04-0114434210.3390/ph14040342Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related DiseasesMattia Bellan0Ailia Giubertoni1Cristina Piccinino2Mariachiara Buffa3Debora Cromi4Daniele Sola5Roberta Pedrazzoli6Ileana Gagliardi7Elisa Calzaducca8Erika Zecca9Filippo Patrucco10Giuseppe Patti11Pier Paolo Sainaghi12Mario Pirisi13Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy“AOU Maggiore della Carità” Hospital, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy“AOU Maggiore della Carità” Hospital, 28100 Novara, Italy“AOU Maggiore della Carità” Hospital, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyDepartment of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, ItalyThe early diagnosis of pulmonary arterial hypertension (PAH) is a major determinant of prognosis in patients affected by connective tissue diseases (CTDs) complicated by PAH. In the present paper we investigated the diagnostic accuracy of cardiopulmonary exercise testing (CPET) in this specific setting. We recorded clinical and laboratory data of 131 patients who underwent a CPET at a pulmonary hypertension clinic. Out of them, 112 (85.5%) had a diagnosis of CTDs; 8 (6.1%) received a diagnosis of CTDs-PAH and 11 (8.4%) were affected PH of different etiology. Among CPET parameters the following parameters showed the best diagnostic performance for PAH: peak volume of oxygen uptake (VO<sub>2</sub>; AUC: 0.845, CI95% 0.767–0.904), ratio between ventilation and volume of exhaled carbon dioxide (VE/VCO<sub>2</sub> slope; AUC: 0.888, CI95%: 0.817–0.938) and end-tidal partial pressures (PetCO<sub>2</sub>; AUC: 0.792, CI95%: 0.709–0.861). These parameters were comparable among CTDs-PAH and PH of different etiology. The diagnostic performance was even improved by creating a composite score which included all the three parameters identified. In conclusion, CPET is a very promising tool for the stratification of risk of PAH among CTDs patients; the use of composite measures may improve diagnostic performance.https://www.mdpi.com/1424-8247/14/4/342pulmonary arterial hypertensionsystemic sclerosissclerodermacardiopulmonary exercise testing |
| spellingShingle | Mattia Bellan Ailia Giubertoni Cristina Piccinino Mariachiara Buffa Debora Cromi Daniele Sola Roberta Pedrazzoli Ileana Gagliardi Elisa Calzaducca Erika Zecca Filippo Patrucco Giuseppe Patti Pier Paolo Sainaghi Mario Pirisi Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases Pharmaceuticals pulmonary arterial hypertension systemic sclerosis scleroderma cardiopulmonary exercise testing |
| title | Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases |
| title_full | Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases |
| title_fullStr | Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases |
| title_full_unstemmed | Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases |
| title_short | Cardiopulmonary Exercise Testing Is an Accurate Tool for the Diagnosis of Pulmonary Arterial Hypertension in Scleroderma Related Diseases |
| title_sort | cardiopulmonary exercise testing is an accurate tool for the diagnosis of pulmonary arterial hypertension in scleroderma related diseases |
| topic | pulmonary arterial hypertension systemic sclerosis scleroderma cardiopulmonary exercise testing |
| url | https://www.mdpi.com/1424-8247/14/4/342 |
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