scholarly journals Cardiopulmonary exercise testing and pulmonary function testing for predicting the severity of CTEPH

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanqing Zhu ◽  
Xingxing Sun ◽  
Yuan Cao ◽  
Bigyan Pudasaini ◽  
Wenlan Yang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Exercise Testing ◽  
Predictive Value ◽  
Minute Ventilation ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Function Testing ◽  
Noninvasive Methods ◽  
Cardiopulmonary Exercise ◽  
Function Testing

Abstract Background Cardiopulmonary exercise testing (CPET) and pulmonary function testing (PFT) are noninvasive methods to evaluate the respiratory and circulatory systems. This research aims to evaluate and monitor chronic thromboembolic pulmonary hypertension (CTEPH) noninvasively and effectively by these two methods. Moreover, the research assesses the predictive value of CPET and PFT parameters for severe CTEPH. Methods We used data from 86 patients with CTEPH (55 for test set, and 31 for validation set) at the Shanghai Pulmonary Hospital Affiliated to Tongji University. The clinical, PFT and CPET data of CTEPH patients of different severity classified according to pulmonary artery pressure (PAP) (mm Hg) were collected and compared. Logistic regression analysis was performed to appraise the predictive value of each PFT and CPET parameter for severe CTEPH. The performance of CPET parameters for predicting severe CTEPH was determined by receiver operating characteristic (ROC) curves and calibration curves. Results Data showed that minute ventilation at anaerobic threshold (VE @ AT) (L/min) and oxygen uptake at peak (VO2 @ peak) (mL/kg/min) were independent predictors for severe CTEPH classified according to PAP (mm Hg). Additionally, the efficacy of VE @ AT (L/min) and VO2 @ peak (mL/kg/min) in identifying severe CTEPH was found to be moderate with the area under ROC curve (AUC) of 0.769 and 0.740, respectively. Furthermore, the combination of VE @ AT (L/min) and VO2 @ peak (mL/kg/min) had a moderate utility value in identifying severe CTEPH with the AUC of 0.843. Conclusion Our research suggests that CPET and PFT can noninvasively and effectively evaluate, monitor and predict the severity of CTEPH.

scholarly journals Cardiopulmonary Exercise Testing and Pulmonary Function Testing for Predicting Aggravation of CTEPH

2021 ◽  
Author(s):  
Zhu Hanqing ◽  
Sun Xingxing ◽  
Cao Yuan ◽  
Yang Wenlan ◽  
Jinming Liu ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Exercise Testing ◽  
Predictive Value ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Roc Curves ◽  
Pulmonary Function Testing ◽  
Noninvasive Methods ◽  
Load Peak ◽  
Function Testing

Abstract BackgroundCardiopulmonary exercise testing (CPET) and pulmonary function testing (PFT) are noninvasive methods to evaluate the respiratory and circulatory systems. This research aimed to evaluate and monitor chronic thromboembolic pulmonary hypertension (CTEPH) noninvasively and effectively. At the same time assess the predictive value of CPET and PFT parameters for the aggravation of CTEPH. MethodsWe used data from 86 CTEPH patients (55 for test set, and 31 for validation set) at the Shanghai Pulmonary Hospital Affiliated to Tongji University. The clinical, PFT and CPET parameters of mild, moderate and severe CPET patients classified according to PAP (mm Hg) were compared. Logistic regression analysis was performed to appraise the predictive value of each potential predictor for severe CTEPH. The performance of PFT and CPET parameters for predicting severe CTEPH was determined by receiver operating characteristic (ROC) curves and calibration curves.ResultsData showed that Load @ Peak (W), FEV1/FVC (%), and VE @ AT (L/min) were independent risk factors for severe CTEPH classified according to PAP (mm Hg). Additionally, the efficacy of the use of Load @ Peak (W), FEV1/FVC (%) and VE @ AT (L/min) in identifying severe CTEPH was found to be moderate with area under the curve (AUC) of ROC curves of 0.736, 0.696 and 0.769, respectively. Furthermore, combination with Load @ Peak (W), FEV1/FVC (%) and VE @ AT (L/min) had a moderate utility value in identifying severe CTEPH with an AUC of 0.897.ConclusionOur data suggests that PFT and CPET parameters can noninvasively and effectively evaluate, monitor and predict the aggravation of CTEPH.

Abstract 16698: Cardiopulmonary Exercise Testing With an In-Line Filter During the COVID-19 Pandemic

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Rohan R Bhat ◽  
Mark W Schoenike ◽  
Alyssa Kowal ◽  
Casey White ◽  
Jennifer Rouvina ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Care Delivery ◽  
Minute Ventilation ◽  
Cardiopulmonary Exercise Testing ◽  
Incremental Exercise ◽  
Cardiopulmonary Exercise ◽  
Asymptomatic Patients ◽  
Filtration System ◽  
Cardiopulmonary Performance ◽  
Function Testing

Introduction: During maximum incremental exercise expiratory flow rates increase > 10-fold and minute ventilation can exceed 100L/min, raising concern for possible spread of COVID-19 in asymptomatic patients undergoing exercise testing. Moreover, use of surgical or N95 masks that limit airflow are recognized to limit the ability to perform maximum exercise. Hypothesis: Use of an in-line filter during cardiopulmonary exercise testing is feasible and will not adversely impact measurements of exercise capacity. Methods: We conducted a proof-of-principle study in which a commercially available electrostat filter (Figure 1A), which has >99.9% viral efficiency without affecting spirometry measurements during pulmonary function testing, was placed in-line, upstream of the flow meter and gas analyzer sample line for use during cardiopulmonary exercise testing. A single healthy subject completed incremental exercise with a 3 min period of unloaded exercise followed by 4-min stages of exercise at 50, 100, 150, and 200W with and without the filter in place on the same day. Mechanical dead space was 53 ml with the filter and 45 ml without. Results: In comparison to no internal filter, use of an in-line filter resulted in VO 2 measurements of 99%, 97%, 98%, and 97% during 50W, 100W, 150W, and 200W, respectively (Figure 1A). VO 2 /work slope measurements and measurements of minute ventilation were also highly consistent throughout exercise with and without use of an in-line filter (Figure 1B). Conclusions: Exercise testing is an integral part of cardiovascular care delivery. Our findings require further validation but suggest that an in-line filtration system can be utilized in an effort to reduce droplet and viral dissemination without impacting measures of cardiopulmonary performance.

scholarly journals The predictive value of preimplant pulmonary function testing in LVAD patients

2020 ◽  
Vol 36 (1) ◽  
pp. 105-110
Author(s):  
Nicholas R. Hess ◽  
Laura M. Seese ◽  
Gavin W. Hickey ◽  
Mary E. Keebler ◽  
Yisi Wang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Predictive Value ◽  
Pulmonary Function Testing ◽  
Function Testing

scholarly journals Correlation Between N-Terminal Pro-Brain Natriuretic Peptide Levels and Cardiopulmonary Exercise Testing in Patients With Pre-Capillary Pulmonary Hypertension: A Pilot Study

2020 ◽  
Vol 14 ◽  
pp. 117954842095404
Author(s):  
Sahachat Aueyingsak ◽  
Wilaiwan Khrisanapant ◽  
Upa Kukongviriyapun ◽  
Orapin Pasurivong ◽  
Pailin Ratanawatkul ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Pulmonary Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Peak Oxygen Uptake ◽  
Cardiopulmonary Exercise ◽  
End Tidal

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiopulmonary exercise testing (CPET) are useful for severity assessment in patients with pulmonary hypertension (PH). Correlations between these tests in pre-capillary PH patients is less well studied. Methods: We studied 23 patients with pre-capillary PH: 8 with idiopathic pulmonary arterial hypertension (IPAH), 6 with systemic sclerosis-associated PAH (SSc-PAH), and 9 with chronic thromboembolic pulmonary hypertension (CTEPH). Clinical evaluation, NT-proBNP levels, six-minute walking test (6MWT), spirometry, and CPET were evaluated on the same day. Correlation between NT-proBNP levels and CPET parameters were investigated. Results: In all patients, NT-proBNP levels were significantly correlated with peak oxygen uptake (VO2) ( r = −0.47), peak oxygen pulse ( r = −0.43), peak cardiac output (CO) ( r = −0.57), peak end-tidal partial pressure of carbon dioxide (PETCO2) ( r = −0.74), ventilatory equivalent to carbon dioxide (VE/VCO2) at anaerobic threshold (AT) ( r = 0.73), and VE/VCO2 slope ( r = 0.64). Significant correlations between NT-proBNP levels and peak PETCO2 and VE/VCO2 were found in IPAH and CTEPH subgroups, and a significant correlation between NT-proBNP levels and VO2 at AT was found in the CTEPH subgroup. No significant correlation was found in the SSc-PAH subgroup. Conclusion: NT-proBNP levels were significantly correlated with CPET parameters in patients with IPAH and CTEPH subgroups, but not in SSc-PAH subgroup. A further study with larger population is required to confirm these preliminary findings.

scholarly journals The Adaptation of Pediatric Exercise Testing Programs to the Coronavirus/COVID-19 Pandemic

2020 ◽  
pp. 215013512095481
Author(s):  
Adam W. Powell ◽  
Wayne A. Mays ◽  
Tracy Curran ◽  
Sandra K. Knecht ◽  
Jonathan Rhodes
Keyword(s):  
Pulmonary Function ◽  
Exercise Testing ◽  
The United States ◽  
Pulmonary Function Testing ◽  
Web Based ◽  
Testing Laboratories ◽  
Hospital Operations ◽  
Surgical Masks ◽  
Exposure Risks ◽  
Function Testing

Objective: Response to the coronavirus/COVID-19 pandemic has resulted in several initiatives that directly impact hospital operations. There has been minimal information on how COVID-19 has affected exercise testing in pediatric patients. Design: A web-based survey was designed and sent to pediatric exercise testing laboratories in the United States and Canada. Questions were designed to understand the initial and ongoing adaptations made by pediatric exercise testing laboratories in response to COVID-19. Results were analyzed as frequency data. Results: There were responses from 42% (35/85) of programs, with 68% (23/34) of laboratories discontinuing all exercise testing. Of the 23 programs that discontinued testing, 15 (65%) are actively working on triage plans to reopen the exercise laboratory. Personal protective equipment use include gloves (96%; 25/26), surgical masks (88%; 23/26), N-95 masks (54%; 14/26), face shields (69%; 18/26), and gowns (62%; 16/26). Approximately 47% (15/32) of programs that typically acquire metabolic measurements reported either ceasing or modifying metabolic measurements during COVID-19. Additionally, 62% (16/26) of the programs that previously obtained pulmonary function testing reported either ceasing or modifying pulmonary function testing. Almost 60% of respondents expressed a desire for additional guidance on exercise laboratory management during COVID-19. Conclusions: Pediatric exercise testing laboratories largely closed during the early pandemic, with many of these programs either now open or working on a plan to open. Despite this, there remains heterogeneity in how to minimize exposure risks to patients and staff. Standardization of exercise testing guidelines during the COVID-19 pandemic may help reduce some of these differences.

scholarly journals The Role of Cardiopulmonary Exercise Test in IPF Prognosis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Christina Triantafillidou ◽  
Effrosyni Manali ◽  
Panagiotis Lyberopoulos ◽  
Likourgos Kolilekas ◽  
Konstantinos Kagouridis ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Exercise Testing ◽  
Risk Estimation ◽  
Minute Ventilation ◽  
Cardiopulmonary Exercise Testing ◽  
Lung Mechanics ◽  
Peak Oxygen Consumption ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise

Background. In IPF, defects in lung mechanics and gas exchange manifest with exercise limitation due to dyspnea, the most prominent and disabling symptom.Aim. To evaluate the role of exercise testing through the 6MWT (6-minute walk test) and CPET (cardiopulmonary exercise testing) in the survival of patients with IPF.Methods. This is a prospective, observational study evaluating in 25 patients the relationship between exercise variables through both the 6MWT and CPET and survival.Results. By the end of the observational period 17 patients were alive (33% mortality). Observation ranged from 9 to 64 months. VE/VCO2slope (slope of relation between minute ventilation and CO2production), VO2peak/kg (peak oxygen consumption/kg), VE/VCO2ratio at anaerobic threshold, 6MWT distance, desaturation, and DLCO% were significant predictors of survival while VE/VCO2slope and VO2peak/kg had the strongest correlation with outcome. The optimal model for mortality risk estimation was VO2peak/kg + DLCO% combined. Furthermore, VE/VCO2slope and VO2peak/kg were correlated with distance and desaturation during the 6MWT.Conclusion. The integration of oxygen consumption and diffusing capacity proved to be a reliable predictor of survival because both variables reflect major underlying physiologic determinants of exercise limitation.

Sign in / Sign up

Export Citation Format

Share Document