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Maximal cardiac output determines 6 minutes walking distance in pulmonary hypertension.
Deboeck, Gaël; Taboada, Dolores; Hagan, Guy; Treacy, Carmen; Page, Kathy; Sheares, Karen; Naeije, Robert; Pepke-Zaba, Joanna.
Afiliación
  • Deboeck G; Erasmus University Hospital, Department of Cardiology, Université Libre de Bruxelles, Brussels, Belgium.
  • Taboada D; Pulmonary Vascular Disease Unit, Papworth Hospital, Papworth, Cambridge, United Kingdom.
  • Hagan G; Pulmonary Vascular Disease Unit, Papworth Hospital, Papworth, Cambridge, United Kingdom.
  • Treacy C; Pulmonary Vascular Disease Unit, Papworth Hospital, Papworth, Cambridge, United Kingdom.
  • Page K; Pulmonary Vascular Disease Unit, Papworth Hospital, Papworth, Cambridge, United Kingdom.
  • Sheares K; Pulmonary Vascular Disease Unit, Papworth Hospital, Papworth, Cambridge, United Kingdom.
  • Naeije R; Department of Physiology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
  • Pepke-Zaba J; Pulmonary Vascular Disease Unit, Papworth Hospital, Papworth, Cambridge, United Kingdom.
PLoS One ; 9(3): e92324, 2014.
Article en En | MEDLINE | ID: mdl-24647561
ABSTRACT

PURPOSE:

The 6 minutes walk test (6MWT) is often shown to be the best predictor of mortality in pulmonary hypertension (PH) probably because it challenges the failing heart to deliver adequate cardiac output. We hypothesised that the 6MWT elicits maximal cardiac output as measured during a maximal cardiopulmonary exercise testing (CPET).

METHODS:

18 patients with chronic thromboembolic pulmonary hypertension (n = 12) or pulmonary arterial hypertension (n = 6) and 10 healthy subjects performed a 6MWT and CPET with measurements of cardiac output (non invasive rebreathing device) before and directly after exercise. Heart rate was measured during 6MWT with a cardiofrequence meter.

RESULTS:

Cardiac output and heart rate measured at the end of the 6MWT were linearly related to 6MW distance (mean±SD 490±87 m). Patients with a high NT-pro-BNP achieve a maximum cardiac output during the 6MWT, while in normal subjects and in patients with a low-normal NT-proBNP, cardiac output at the end of a 6MWT was lower than achieved at maximum exercise during a CPET. In both cases, heart rate is the major determinant of exercise-induced increase in cardiac output. However, stroke volume increased during CPET in healthy subjects, not in PH patients.

CONCLUSION:

Maximal cardiac output is elicited by 6MWT in PH patients with failing right ventricle. Cardiac output increase is dependent on chronotropic response in patients with PH.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Gasto Cardíaco / Prueba de Esfuerzo / Hipertensión Pulmonar Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2014 Tipo del documento: Article País de afiliación: Bélgica

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Gasto Cardíaco / Prueba de Esfuerzo / Hipertensión Pulmonar Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2014 Tipo del documento: Article País de afiliación: Bélgica