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. 2018 Mar 23;18(1):56.
doi: 10.1186/s12872-018-0783-7.

Characteristics of exercise capacity in female systemic lupus erythematosus associated pulmonary arterial hypertension patients

Bigyan Pudasaini  1   2 , Guo-Ling Yang  2 , Chen Yang  2 , Jian Guo  1 , Ping Yuan  2 , Yang Wen-Lan  1 , Rui Zhang  2 , Lan Wang  2 , Qin-Hua Zhao  2 , Su-Gang Gong  2 , Rong Jiang  2 , Tian-Xiang Chen  2 , Xiong Wei  1 , Jin-Ming Liu  3   4   5
Affiliations

Characteristics of exercise capacity in female systemic lupus erythematosus associated pulmonary arterial hypertension patients

Bigyan Pudasaini et al. BMC Cardiovasc Disord. .

Abstract

Background: To study the oxygen uptake efficiency and determine usefulness of submaximal parameters of oxygen uptake in systemic lupus erythematosus associated pulmonary arterial hypertension (SLE PAH) on performing a cardiopulmonary exercise test (CPET).

Methods: CPET was performed in 21 SLE PAH patients, equal number of idiopathic pulmonary arterial hypertension (IPAH) patients and controls. Peak VO2, anaerobic threshold (AT), oxygen uptake efficiency slope (OUES) and oxygen uptake efficiency plateau (OUEP) and other CPET parameters were examined. All subjects had pulmonary function test (PFT) at rest, which included FEV1, FVC, FEV1/FVC, DLCO measurements. Right heart catheterization (RHC) was also done in SLE PAH and IPAH patients. CPET parameters were compared with RHC parameters to determine potential correlations.

Results: Peak VO2, PETCO2 and peak O2 pulse were lower in SLE PAH than IPAH and controls with OUE being lower during all stages of exercise in SLE PAH. DLCO and FVC values were significantly lower in SLE PAH (p < 0.05). Peak O2 pulse and VO2@AT in SLE PAH and IPAH was low (p < 0.05) and significant difference between SLE PAH and IPAH was seen (p < 0.05). PVR correlated with the lowest VE/VCO2, O2 pulse, peak PETCO2 and OUE in SLE PAH patients (all p < 0.05).

Conclusions: SLE PAH patients have cardiopulmonary exercise limitation with reduced oxygen uptake efficiency. VO2@ at AT, peak O2 pulse and O2 pulse at AT were significantly reduced (p < 0.05). Key CPET parameters correlated with elevated pulmonary vascular resistance (PVR). Submaximal parameters of oxygen uptake are equally useful in SLE PAH.

Keywords: Cardiopulmonary exercise testing; Idiopathic pulmonary arterial hypertension; Oxygen uptake efficiency; PVR; Systemic lupus erythematosus associated pulmonary arterial hypertension.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval to conduct this study was obtained from Shanghai pulmonary hospital’s ethical board and all participants gave written informed consent to participate in this study. The study was performed in accordance with the declaration of Helsinki.

Consent for publication

All authors had access to all the data used during the course of preparing this manuscript and all authors approved the manuscript prior to sending out for publication.

Competing interests

We have read BioMed Central’s guidance on competing interests and declare that none of the authors have any competing interests-financial or otherwise.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a PVR trends in SLE PAH and IPAH, b Heart rate during the different exercise stages in SLE PAH, IPAH & controls, c VO2 in SLE PAH, IPAH & controls, d VO2/VE i.e. OUE in the three groups during different phases of CPET
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