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Comparative Study
. 2021 Oct 18;21(1):324.
doi: 10.1186/s12890-021-01668-3.

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

Hanqing Zhu #  1 , Xingxing Sun #  1 , Yuan Cao  1 , Bigyan Pudasaini  2 , Wenlan Yang  1 , Jinming Liu  1 , Jian Guo  3
Affiliations
Comparative Study

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

Hanqing Zhu et al. BMC Pulm Med. .

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.

Keywords: CPET; CTEPH; PFT.

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Conflict of interest statement

The authors confirm that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Predictors of severe CTEPH on multivariable analysis of CPET and PFT parameters. Range for “Severe”: PAP (mm Hg) ≥ 45. Results are expressed as odds ratio (OR) with 95% confidence interval (95% CI). VE = minute ventilation; VO2 = oxygen uptake
Fig. 2
Fig. 2
Performance of CPET parameters for the prediction of severe CTEPH. A Receiver operating characteristic (ROC) curves for single factor and multiple factors that predict severe CTEPH. B Calibration curves for single factor and multiple factors that predict severe CTEPH
See this image and copyright information in PMC

References

    1. Guazzi M, Bandera F, Ozemek C, Systrom D, Arena R. Cardiopulmonary exercise testing: what is its value? J Am Coll Cardiol. 2017;70:1618–1636. doi: 10.1016/j.jacc.2017.08.012. - DOI - PubMed
    1. Tran D. Cardiopulmonary exercise testing. Methods in molecular biology (Clifton, NJ) 2018;1735:285–295. doi: 10.1007/978-1-4939-7614-0_18. - DOI - PubMed
    1. Weatherald J, Farina S, Bruno N, Laveneziana P. Cardiopulmonary exercise testing in pulmonary hypertension. Ann Am Thorac Soc. 2017;14:S84–S92. doi: 10.1513/AnnalsATS.201610-788FR. - DOI - PubMed
    1. Malhotra R, Bakken K, D'Elia E, Lewis GD. Cardiopulmonary exercise testing in heart failure. JACC Heart failure. 2016;4:607–616. doi: 10.1016/j.jchf.2016.03.022. - DOI - PubMed
    1. Boutou AK, Daniil Z, Pitsiou G, Papakosta D, Kioumis I, Stanopoulos I. Cardiopulmonary exercise testing in patients with asthma: What is its clinical value? Respir Med. 2020;167:105953. doi: 10.1016/j.rmed.2020.105953. - DOI - PubMed

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