Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease
Abstract Background Pulmonary hypertension in left heart disease (PH-LHD), which includes combined post- and precapillary PH (Cpc-PH) and isolated postcapillary PH (Ipc-PH), differs significantly in prognosis. We aimed to assess whether cardiopulmonary exercise testing (CPET) predicts the long-term...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02574-0 |
| _version_ | 1819052434010406912 |
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| author | Xiu-Jun Zhong Rong Jiang Lu Yang Ping Yuan Su-Gang Gong Qin-Hua Zhao Ci-Jun Luo Hong-Ling Qiu Hui-Ting Li Rui Zhang Jing He Lan Wang Jie Tang Jin-Ming Liu |
| author_facet | Xiu-Jun Zhong Rong Jiang Lu Yang Ping Yuan Su-Gang Gong Qin-Hua Zhao Ci-Jun Luo Hong-Ling Qiu Hui-Ting Li Rui Zhang Jing He Lan Wang Jie Tang Jin-Ming Liu |
| author_sort | Xiu-Jun Zhong |
| collection | DOAJ |
| description | Abstract Background Pulmonary hypertension in left heart disease (PH-LHD), which includes combined post- and precapillary PH (Cpc-PH) and isolated postcapillary PH (Ipc-PH), differs significantly in prognosis. We aimed to assess whether cardiopulmonary exercise testing (CPET) predicts the long-term survival of patients with PH-LHD. Methods A single-center observational cohort enrolled 89 patients with PH-LHD who had undergone right heart catherization and CPET (mean pulmonary arterial pressure > 20 mm Hg and pulmonary artery wedge pressure ≥ 15 mm Hg) between 2013 and 2021. A receiver operating characteristic curve was plotted to determine the cutoff value of all-cause death. Survival was estimated using the Kaplan–Meier method and analyzed using the log-rank test. The Cox proportional hazards model was performed to determine the association between CPET and all-cause death. Results Seventeen patients died within a mean of 2.2 ± 1.3 years. Compared with survivors, nonsurvivors displayed a significantly worse 6-min walk distance, workload, exercise time and peak oxygen consumption (VO2)/kg with a trend of a lower oxygen uptake efficiency slope (OUES) adjusted by Bonferroni’s correction. Multivariate Cox regression revealed that the peak VO2/kg was significantly associated with all-cause death after adjusting for Cpc-PH/Ipc-PH. Compared with Cpc-PH patients with a peak VO2/kg ≥ 10.7 ml kg−1 min−1, Ipc-PH patients with a peak VO2/kg < 10.7 ml kg−1 min−1 had a worse survival (P < 0.001). Conclusions The peak VO2/kg is independently associated with all-cause death in patients with PH-LHD. The peak VO2/kg can also be analyzed together with Cpc-PH/Ipc-PH to better indicate the prognosis of patients with PH-LHD. |
| first_indexed | 2024-12-21T12:19:46Z |
| format | Article |
| id | doaj.art-d31b1ecfbafb463e816083876b5629f3 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-21T12:19:46Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-d31b1ecfbafb463e816083876b5629f32022-12-21T19:04:21ZengBMCBMC Cardiovascular Disorders1471-22612022-03-0122111010.1186/s12872-022-02574-0Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart diseaseXiu-Jun Zhong0Rong Jiang1Lu Yang2Ping Yuan3Su-Gang Gong4Qin-Hua Zhao5Ci-Jun Luo6Hong-Ling Qiu7Hui-Ting Li8Rui Zhang9Jing He10Lan Wang11Jie Tang12Jin-Ming Liu13Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardiology, Second Affiliated Hospital of Nanchang UniversityDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineDepartment of Respiratory Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese MedicineDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of MedicineAbstract Background Pulmonary hypertension in left heart disease (PH-LHD), which includes combined post- and precapillary PH (Cpc-PH) and isolated postcapillary PH (Ipc-PH), differs significantly in prognosis. We aimed to assess whether cardiopulmonary exercise testing (CPET) predicts the long-term survival of patients with PH-LHD. Methods A single-center observational cohort enrolled 89 patients with PH-LHD who had undergone right heart catherization and CPET (mean pulmonary arterial pressure > 20 mm Hg and pulmonary artery wedge pressure ≥ 15 mm Hg) between 2013 and 2021. A receiver operating characteristic curve was plotted to determine the cutoff value of all-cause death. Survival was estimated using the Kaplan–Meier method and analyzed using the log-rank test. The Cox proportional hazards model was performed to determine the association between CPET and all-cause death. Results Seventeen patients died within a mean of 2.2 ± 1.3 years. Compared with survivors, nonsurvivors displayed a significantly worse 6-min walk distance, workload, exercise time and peak oxygen consumption (VO2)/kg with a trend of a lower oxygen uptake efficiency slope (OUES) adjusted by Bonferroni’s correction. Multivariate Cox regression revealed that the peak VO2/kg was significantly associated with all-cause death after adjusting for Cpc-PH/Ipc-PH. Compared with Cpc-PH patients with a peak VO2/kg ≥ 10.7 ml kg−1 min−1, Ipc-PH patients with a peak VO2/kg < 10.7 ml kg−1 min−1 had a worse survival (P < 0.001). Conclusions The peak VO2/kg is independently associated with all-cause death in patients with PH-LHD. The peak VO2/kg can also be analyzed together with Cpc-PH/Ipc-PH to better indicate the prognosis of patients with PH-LHD.https://doi.org/10.1186/s12872-022-02574-0Pulmonary hypertension due to left heart diseasePrognosisPeak oxygen consumptionCombined post- and precapillary pulmonary hypertensionIsolated postcapillary pulmonary hypertension |
| spellingShingle | Xiu-Jun Zhong Rong Jiang Lu Yang Ping Yuan Su-Gang Gong Qin-Hua Zhao Ci-Jun Luo Hong-Ling Qiu Hui-Ting Li Rui Zhang Jing He Lan Wang Jie Tang Jin-Ming Liu Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease BMC Cardiovascular Disorders Pulmonary hypertension due to left heart disease Prognosis Peak oxygen consumption Combined post- and precapillary pulmonary hypertension Isolated postcapillary pulmonary hypertension |
| title | Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease |
| title_full | Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease |
| title_fullStr | Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease |
| title_full_unstemmed | Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease |
| title_short | Peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease |
| title_sort | peak oxygen uptake is a strong prognostic predictor for pulmonary hypertension due to left heart disease |
| topic | Pulmonary hypertension due to left heart disease Prognosis Peak oxygen consumption Combined post- and precapillary pulmonary hypertension Isolated postcapillary pulmonary hypertension |
| url | https://doi.org/10.1186/s12872-022-02574-0 |
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