Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion?
Exercise-induced pulmonary hypertension EIPH has been defined as an increase in mean pulmonary arterial pressure (mPAP) during exercise in otherwise normal values at rest. EIPH reflects heart and/or lung dysfunction and may precede the development of manifest pulmonary hypertension (PH) in a proport...
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MDPI AG
2023-01-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/1/128 |
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| author | Elina Khattab Nikolaos Velidakis Evaggelia Gkougkoudi Nikolaos P.E. Kadoglou |
| author_facet | Elina Khattab Nikolaos Velidakis Evaggelia Gkougkoudi Nikolaos P.E. Kadoglou |
| author_sort | Elina Khattab |
| collection | DOAJ |
| description | Exercise-induced pulmonary hypertension EIPH has been defined as an increase in mean pulmonary arterial pressure (mPAP) during exercise in otherwise normal values at rest. EIPH reflects heart and/or lung dysfunction and may precede the development of manifest pulmonary hypertension (PH) in a proportion of patients. It is also associated with decreased life expectancy in patients with heart failure with reduced ejection fraction (HFrEF) or left ventricle (LV) valvular diseases. Diastolic dysfunction exacerbated during exercise relates to increased LV filling pressure and left atrial pressure (LAP). In this context backward, transmitted pressure alone or accompanied with backward blood flow promotes EIPH. The gold standard of EIPH assessment remains the right heart catheterization during exercise, which is an accurate but invasive method. Alternatively, non-invasive diagnostic modalities include exercise stress echocardiography (ESE) and cardiopulmonary exercise testing (CPET). Both diagnostic tests are performed under gradually increasing physical stress using treadmill and ergo-cycling protocols. Escalating workload during the exercise is analogous to the physiological response to real exercise. The results of the latter techniques show good correlation with invasive measurements, but they suffer from lack of validation and cut-off value determination. Although it is not officially recommended, there are accumulated data supporting the importance of EIPH diagnosis in the assessment of other mild/subclinical or probably fatal diseases in patients with latent PH or heart failure or LV valvular disease, respectively. Nevertheless, larger, prospective studies are required to ensure its role in clinical practice. |
| first_indexed | 2024-03-09T11:56:31Z |
| format | Article |
| id | doaj.art-5beb6d37908a45ad9edd6651bb7e20ef |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T11:56:31Z |
| publishDate | 2023-01-01 |
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| series | Life |
| spelling | doaj.art-5beb6d37908a45ad9edd6651bb7e20ef2023-11-30T23:08:24ZengMDPI AGLife2075-17292023-01-0113112810.3390/life13010128Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion?Elina Khattab0Nikolaos Velidakis1Evaggelia Gkougkoudi2Nikolaos P.E. Kadoglou3Medical School, University of Cyprus, 2029 Nicosia, CyprusMedical School, University of Cyprus, 2029 Nicosia, CyprusMedical School, University of Cyprus, 2029 Nicosia, CyprusMedical School, University of Cyprus, 2029 Nicosia, CyprusExercise-induced pulmonary hypertension EIPH has been defined as an increase in mean pulmonary arterial pressure (mPAP) during exercise in otherwise normal values at rest. EIPH reflects heart and/or lung dysfunction and may precede the development of manifest pulmonary hypertension (PH) in a proportion of patients. It is also associated with decreased life expectancy in patients with heart failure with reduced ejection fraction (HFrEF) or left ventricle (LV) valvular diseases. Diastolic dysfunction exacerbated during exercise relates to increased LV filling pressure and left atrial pressure (LAP). In this context backward, transmitted pressure alone or accompanied with backward blood flow promotes EIPH. The gold standard of EIPH assessment remains the right heart catheterization during exercise, which is an accurate but invasive method. Alternatively, non-invasive diagnostic modalities include exercise stress echocardiography (ESE) and cardiopulmonary exercise testing (CPET). Both diagnostic tests are performed under gradually increasing physical stress using treadmill and ergo-cycling protocols. Escalating workload during the exercise is analogous to the physiological response to real exercise. The results of the latter techniques show good correlation with invasive measurements, but they suffer from lack of validation and cut-off value determination. Although it is not officially recommended, there are accumulated data supporting the importance of EIPH diagnosis in the assessment of other mild/subclinical or probably fatal diseases in patients with latent PH or heart failure or LV valvular disease, respectively. Nevertheless, larger, prospective studies are required to ensure its role in clinical practice.https://www.mdpi.com/2075-1729/13/1/128exercise-induced pulmonary hypertension (EIPH)pathophysiologyright heart catheterization (RHC)exercise stress echocardiography (ESE)cardiopulmonary exercise testing (CPET) |
| spellingShingle | Elina Khattab Nikolaos Velidakis Evaggelia Gkougkoudi Nikolaos P.E. Kadoglou Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion? Life exercise-induced pulmonary hypertension (EIPH) pathophysiology right heart catheterization (RHC) exercise stress echocardiography (ESE) cardiopulmonary exercise testing (CPET) |
| title | Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion? |
| title_full | Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion? |
| title_fullStr | Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion? |
| title_full_unstemmed | Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion? |
| title_short | Exercise-Induced Pulmonary Hypertension: A Valid Entity or Another Factor of Confusion? |
| title_sort | exercise induced pulmonary hypertension a valid entity or another factor of confusion |
| topic | exercise-induced pulmonary hypertension (EIPH) pathophysiology right heart catheterization (RHC) exercise stress echocardiography (ESE) cardiopulmonary exercise testing (CPET) |
| url | https://www.mdpi.com/2075-1729/13/1/128 |
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