Prognostic Relevance of Changes in Exercise Test Variables in Pulmonary Arterial Hypertension
Prognostic Relevance of Changes in Exercise Test Variables in Pulmonary Arterial Hypertension
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DOI：
10.1371/journal.pone.0072013
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发表时间：
2013-09-05
期刊：
影响因子：
3.7
通讯作者：
Bogaard, Harm J.
中科院分区：
文献类型：
--
作者：
Groepenhoff, Herman;Vonk-Noordegraaf, Anton;Bogaard, Harm J.
引言：肺动脉高压（PAH）患者在诊断时确定的运动变量可预测生存率。目前尚不清楚治疗后，这些运动变量的后续变化是否反映了生存率的改善。本研究的目的是确定PAH患者运动变量的变化，并将这些变化与survival.Methods：基线心肺运动试验（CPET）变量和6分钟步行距离（6 MWD）可从65例特发性PAH患者（50名女性，平均年龄45 +/-2岁）。在43例患者的亚组中，在治疗后（13个月）确定了相同的变量。为了评估运动变量变化与心功能变化之间的相关性，通过心脏MRI测量了34例患者基线和治疗后的右心室射血分数（RVEF）。第二次CPET后的平均随访时间为53（范围：4-111）个月。Kaplan-Meier分析用于将生存与基线和治疗相关的运动variables.Results的变化：幸存者表现出显着更大的变化，最大摄氧量比非幸存者和有氧能力的变化是显着相关的RVEF的变化。从基线到研究期结束，2例患者接受了肺移植，19例患者死亡。生存分析显示基线6 MWD（p
Introduction: Exercise variables determined in patients with pulmonary arterial hypertension (PAH) at the time of diagnosis, predict survival. It is unknown whether upon treatment, subsequent changes in these exercise variables reflect improvements in survival. The aim of this study was to determine changes in exercise variables in PAH patients and to relate these changes to survival.Methods: Baseline cardiopulmonary exercise test (CPET) variables and six-minute-walk-distance (6MWD) were available from 65 idiopathic PAH patients (50 females; mean age 45 +/- 2yrs). The same variables were determined after treatment (13months) in a sub group of 43 patients. To estimate the association between changes in exercise variables and changes in cardiac function, right-ventricle ejection fraction (RVEF) was measured by cardiac MRI at baseline and after treatment in 34 patients. Mean follow-up time after the second CPET was 53 (range: 4-111) months. Kaplan-Meier analysis was used to relate survival to baseline and treatment-associated changes in exercise variables.Results: Survivors showed a significantly greater change in maximal oxygen uptake than non-survivors and this change in aerobic capacity was significantly related to changes in RVEF. From baseline until the end of the study period, two patients underwent a lung transplantation and 19 patients died. Survival analysis showed that baseline 6MWD (p