Pulmonary Vascular Disease and Cardiopulmonary Exercise Testing

Overview

Journal Front Physiol

Date 2020 Aug 28

PMID 32848882

Citations 8

Authors

Pierantonio Laveneziana

Jason Weatherald

Affiliations

Soon will be listed here.

Abstract

Cardiopulmonary exercise testing (CPET) is of great interest and utility for clinicians dealing Pulmonary Hypertension (PH) in several ways, including: helping with differential diagnosis, evaluating exercise intolerance and its underpinning mechanisms, accurately assessing exertional dyspnea and unmasking its underlying often non-straightforward mechanisms, generating prognostic indicators. Pathophysiologic anomalies in PH can range from reduced cardiac output and aerobic capacity, to inefficient ventilation, dyspnea, dynamic hyperinflation, and locomotor muscle dysfunction. CPET can magnify the PH-related pathophysiologic anomalies and has a major role in the management of PH patients.

Citing Articles

Physical exercise for pulmonary arterial hypertension diagnosis and therapy.

Lwin M, Masding A, McCabe C Int J Cardiol Congenit Heart Dis. 2025; 19:100565.

PMID: 40066343 PMC: 11891737. DOI: 10.1016/j.ijcchd.2025.100565.

Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism.

Khilzi K, Piccari L, Franco G, Rodo-Pin A, Herranz A, Blanco I Pulm Circ. 2025; 15(1):e70045.

PMID: 39917073 PMC: 11798863. DOI: 10.1002/pul2.70045.

Identifying limitations to exercise with incremental cardiopulmonary exercise testing: a scoping review.

Staes M, Gyselinck I, Goetschalckx K, Troosters T, Janssens W Eur Respir Rev. 2024; 33(173).

PMID: 39231595 PMC: 11372471. DOI: 10.1183/16000617.0010-2024.

Differences in Exercise Capacity, Ventilatory Efficiency, and Gas Exchange between Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension Residing at High Altitude.

Gonzalez-Garcia M, Conde-Camacho R, Diaz K, Rodriguez-Cortes C, Rincon-Alvarez E Rev Cardiovasc Med. 2024; 25(7):247.

PMID: 39139420 PMC: 11317340. DOI: 10.31083/j.rcm2507247.

Exercise Testing in Patients with Pulmonary Hypertension.

Vaidy A, Vahdatpour C, Mazurek J J Clin Med. 2024; 13(3).

PMID: 38337493 PMC: 10855991. DOI: 10.3390/jcm13030795.

References

Hoeper M, Pletz M, Golpon H, Welte T . Prognostic value of blood gas analyses in patients with idiopathic pulmonary arterial hypertension. Eur Respir J. 2007; 29(5):944-50. DOI: 10.1183/09031936.00134506. View

Dorneles R, Plachi F, Gass R, Toniazzo V, Thome P, Sanches P . Sensory consequences of critical inspiratory constraints during exercise in pulmonary arterial hypertension. Respir Physiol Neurobiol. 2019; 261:40-47. DOI: 10.1016/j.resp.2019.01.002. View

Wensel R, Opitz C, Anker S, Winkler J, Hoffken G, Kleber F . Assessment of survival in patients with primary pulmonary hypertension: importance of cardiopulmonary exercise testing. Circulation. 2002; 106(3):319-24. DOI: 10.1161/01.cir.0000022687.18568.2a. View

Whipp B, Ward S . Determinants and control of breathing during muscular exercise. Br J Sports Med. 1998; 32(3):199-211. PMC: 1756098. DOI: 10.1136/bjsm.32.3.199. View

Zhai Z, Murphy K, Tighe H, Wang C, Wilkins M, Gibbs J . Differences in ventilatory inefficiency between pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Chest. 2011; 140(5):1284-1291. DOI: 10.1378/chest.10-3357. View

Palange P, Ward S, Carlsen K, Casaburi R, Gallagher C, Gosselink R . Recommendations on the use of exercise testing in clinical practice. Eur Respir J. 2007; 29(1):185-209. DOI: 10.1183/09031936.00046906. View

Kovacs G, Herve P, Barbera J, Chaouat A, Chemla D, Condliffe R . An official European Respiratory Society statement: pulmonary haemodynamics during exercise. Eur Respir J. 2017; 50(5). DOI: 10.1183/13993003.00578-2017. View

Laveneziana P, Montani D, Dorfmuller P, Girerd B, Sitbon O, Jais X . Mechanisms of exertional dyspnoea in pulmonary veno-occlusive disease with EIF2AK4 mutations. Eur Respir J. 2014; 44(4):1069-72. DOI: 10.1183/09031936.00088914. View

Badagliacca R, Papa S, Poscia R, Valli G, Pezzuto B, Manzi G . The added value of cardiopulmonary exercise testing in the follow-up of pulmonary arterial hypertension. J Heart Lung Transplant. 2018; 38(3):306-314. DOI: 10.1016/j.healun.2018.11.015. View

10.

Tolle J, Waxman A, Systrom D . Impaired systemic oxygen extraction at maximum exercise in pulmonary hypertension. Med Sci Sports Exerc. 2007; 40(1):3-8. DOI: 10.1249/mss.0b013e318159d1b8. View

11.

Groepenhoff H, Vonk-Noordegraaf A, van de Veerdonk M, Boonstra A, Westerhof N, Bogaard H . Prognostic relevance of changes in exercise test variables in pulmonary arterial hypertension. PLoS One. 2013; 8(9):e72013. PMC: 3764059. DOI: 10.1371/journal.pone.0072013. View

12.

Soumagne T, Laveneziana P, Veil-Picard M, Guillien A, Claude F, Puyraveau M . Asymptomatic subjects with airway obstruction have significant impairment at exercise. Thorax. 2016; 71(9):804-11. DOI: 10.1136/thoraxjnl-2015-207953. View

13.

Groepenhoff H, Vonk-Noordegraaf A, Boonstra A, Spreeuwenberg M, Postmus P, Bogaard H . Exercise testing to estimate survival in pulmonary hypertension. Med Sci Sports Exerc. 2008; 40(10):1725-32. DOI: 10.1249/MSS.0b013e31817c92c0. View

14.

Godinas L, Sattler C, Lau E, Jais X, Taniguchi Y, Jevnikar M . Dead-space ventilation is linked to exercise capacity and survival in distal chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant. 2017; 36(11):1234-1242. DOI: 10.1016/j.healun.2017.05.024. View

15.

Radtke T, Crook S, Kaltsakas G, Louvaris Z, Berton D, Urquhart D . ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases. Eur Respir Rev. 2019; 28(154). PMC: 9488712. DOI: 10.1183/16000617.0101-2018. View

16.

Schwaiblmair M, Faul C, von Scheidt W, Berghaus T . Ventilatory efficiency testing as prognostic value in patients with pulmonary hypertension. BMC Pulm Med. 2012; 12:23. PMC: 3420250. DOI: 10.1186/1471-2466-12-23. View

17.

Velez-Roa S, Ciarka A, Najem B, Vachiery J, Naeije R, van de Borne P . Increased sympathetic nerve activity in pulmonary artery hypertension. Circulation. 2004; 110(10):1308-12. DOI: 10.1161/01.CIR.0000140724.90898.D3. View

18.

Mereles D, Ehlken N, Kreuscher S, Ghofrani S, Hoeper M, Halank M . Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation. 2006; 114(14):1482-9. DOI: 10.1161/CIRCULATIONAHA.106.618397. View

19.

Hasler E, Muller-Mottet S, Furian M, Saxer S, Huber L, Maggiorini M . Pressure-Flow During Exercise Catheterization Predicts Survival in Pulmonary Hypertension. Chest. 2016; 150(1):57-67. DOI: 10.1016/j.chest.2016.02.634. View

20.

Galie N, Rubin L, Hoeper M, Jansa P, Al-Hiti H, Meyer G . Treatment of patients with mildly symptomatic pulmonary arterial hypertension with bosentan (EARLY study): a double-blind, randomised controlled trial. Lancet. 2008; 371(9630):2093-100. DOI: 10.1016/S0140-6736(08)60919-8. View