Cardiopulmonary exercise testing to evaluate the exercise capacity of patients with inoperable chronic thromboembolic pulmonary hypertension: an endothelin receptor antagonist improves the peak PETCO2.
Cardiopulmonary exercise testing to evaluate the exercise capacity of patients with inoperable chronic thromboembolic pulmonary hypertension: an endothelin receptor antagonist improves the peak PETCO2.
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DOI：
10.1016/j.lfs.2014.03.009
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发表时间：
2014-11
期刊：
影响因子：
6.1
通讯作者：
A. Hirashiki;S. Adachi;Y. Nakano;Y. Kono;S. Shimazu;S. Shimizu;R. Morimoto;T. Okumura;Kyosuke Takeshita;S. Yamada;T. Murohara;T. Kondo
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文献类型：
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作者：
A. Hirashiki;S. Adachi;Y. Nakano;Y. Kono;S. Shimazu;S. Shimizu;R. Morimoto;T. Okumura;Kyosuke Takeshita;S. Yamada;T. Murohara;T. Kondo
目的6 min步行距离常用于评价慢性血栓栓塞性肺动脉高压（CTEPH）患者在内皮素受体拮抗剂（ERA）治疗下的运动能力。运动心肺功能试验（CPX）对肺动脉高压（PAH）患者更有价值，但对不能手术的CTEPH患者的应用报道较少。本研究的目的是调查的影响，口服双ERA，波生坦，运动能力使用CPX在PAH和不可操作CTEPH患者。主要methodsThis研究包括所有患者诊断为17 PAH和12 CTEPH在世界卫生组织功能类II-IV谁开始治疗波生坦治疗。他们接受了CPX，这是在波生坦治疗前和治疗后3至6个月进行的。另一方面，在CTEPH患者中，峰值VO 2无显著差异。然而，PETCO 2峰值从基线时的23.9 ± 5.2 mmHg显著增加至波生坦治疗后的29.3 ± 10.7 mmHg（p = 0.040）。此外，波生坦治疗后运动时的峰值心率趋于降低（p = 0.089）。波生坦治疗可改善不可手术CTEPH患者的PETCO 2峰值，但不能改善VO 2峰值。这些结果表明，CPX可用于评估接受ERA治疗的PAH和无法手术的CTEPH患者的运动能力。
AimsThe 6-min walking distance is often used for assessing the exercise capacity under the treatment with an endothelin receptor antagonist (ERA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The cardiopulmonary exercise testing (CPX) was reported to be more useful for the patients with pulmonary arterial hypertension (PAH), however, few reports exist in patients with inoperable CTEPH. The aim of this study was to investigate the effects of an oral dual ERA, bosentan, on exercise capacity using CPX in patients with PAH and inoperable CTEPH.Main methodsThis study included all patients diagnosed with 17 PAH and 12 CTEPH in the World Health Organization functional classes II–IV who started treatment with bosentan therapy. They underwent CPX, which was performed before bosentan therapy and at 3 to 6 months of the treatment.Key findingsIn PAH patients, peak VO2significantly increased after the bosentan treatment (p = 0.009). On the other hand, in CTEPH patients, there were no significant differences in the peak VO2. However, the peak PETCO2was significantly increased from 23.9 ± 5.2 mm Hg at baseline to 29.3 ± 10.7 mm Hg after the bosentan treatment (p = 0.040). In addition, peak heart rate during exercise tended to decrease after the bosentan therapy (p = 0.089).SignificanceBosentan therapy improved peak PETCO2but not peak VO2in patients with inoperable CTEPH. These findings demonstrated that CPX is useful for assessing the exercise capacity of patients with PAH and inoperable CTEPH under the treatment with an ERA.