Ventilatory efficiency in pulmonary vascular diseases
Cardiopulmonary exercise testing (CPET) is a frequently used tool in the differential diagnosis of dyspnoea. Ventilatory inefficiency, defined as high minute ventilation (V′E) relative to carbon dioxide output (V′CO2), is a hallmark characteristic of pulmonary vascular diseases, which contributes to...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2021-07-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/30/161/200214.full |
| _version_ | 1819147742309515264 |
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| author | Jason Weatherald Brianne Philipenko David Montani Pierantonio Laveneziana |
| author_facet | Jason Weatherald Brianne Philipenko David Montani Pierantonio Laveneziana |
| author_sort | Jason Weatherald |
| collection | DOAJ |
| description | Cardiopulmonary exercise testing (CPET) is a frequently used tool in the differential diagnosis of dyspnoea. Ventilatory inefficiency, defined as high minute ventilation (V′E) relative to carbon dioxide output (V′CO2), is a hallmark characteristic of pulmonary vascular diseases, which contributes to exercise intolerance and disability in these patients. The mechanisms of ventilatory inefficiency are multiple and include high physiologic dead space, abnormal chemosensitivity and an altered carbon dioxide (CO2) set-point. A normal V′E/V′CO2 makes a pulmonary vascular disease such as pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) unlikely. The finding of high V′E/V′CO2 without an alternative explanation should prompt further diagnostic testing to exclude PAH or CTEPH, particularly in patients with risk factors, such as prior venous thromboembolism, systemic sclerosis or a family history of PAH. In patients with established PAH or CTEPH, the V′E/V′CO2 may improve with interventions and is a prognostic marker. However, further studies are needed to clarify the added value of assessing ventilatory inefficiency in the longitudinal follow-up of patients. |
| first_indexed | 2024-12-22T13:34:39Z |
| format | Article |
| id | doaj.art-0d6fb816d9564e86ad94b9ac104a00d4 |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-12-22T13:34:39Z |
| publishDate | 2021-07-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-0d6fb816d9564e86ad94b9ac104a00d42022-12-21T18:24:04ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172021-07-013016110.1183/16000617.0214-20200214-2020Ventilatory efficiency in pulmonary vascular diseasesJason Weatherald0Brianne Philipenko1David Montani2Pierantonio Laveneziana3 Dept of Medicine, Division of Respirology, University of Calgary, Cumming School of Medicine, Calgary, Canada Dept of Medicine, Division of Respirology, University of Calgary, Cumming School of Medicine, Calgary, Canada Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France Sorbonne Université, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France Cardiopulmonary exercise testing (CPET) is a frequently used tool in the differential diagnosis of dyspnoea. Ventilatory inefficiency, defined as high minute ventilation (V′E) relative to carbon dioxide output (V′CO2), is a hallmark characteristic of pulmonary vascular diseases, which contributes to exercise intolerance and disability in these patients. The mechanisms of ventilatory inefficiency are multiple and include high physiologic dead space, abnormal chemosensitivity and an altered carbon dioxide (CO2) set-point. A normal V′E/V′CO2 makes a pulmonary vascular disease such as pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) unlikely. The finding of high V′E/V′CO2 without an alternative explanation should prompt further diagnostic testing to exclude PAH or CTEPH, particularly in patients with risk factors, such as prior venous thromboembolism, systemic sclerosis or a family history of PAH. In patients with established PAH or CTEPH, the V′E/V′CO2 may improve with interventions and is a prognostic marker. However, further studies are needed to clarify the added value of assessing ventilatory inefficiency in the longitudinal follow-up of patients.http://err.ersjournals.com/content/30/161/200214.full |
| spellingShingle | Jason Weatherald Brianne Philipenko David Montani Pierantonio Laveneziana Ventilatory efficiency in pulmonary vascular diseases European Respiratory Review |
| title | Ventilatory efficiency in pulmonary vascular diseases |
| title_full | Ventilatory efficiency in pulmonary vascular diseases |
| title_fullStr | Ventilatory efficiency in pulmonary vascular diseases |
| title_full_unstemmed | Ventilatory efficiency in pulmonary vascular diseases |
| title_short | Ventilatory efficiency in pulmonary vascular diseases |
| title_sort | ventilatory efficiency in pulmonary vascular diseases |
| url | http://err.ersjournals.com/content/30/161/200214.full |
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