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Review
. 2022 Sep 12:13:963881.
doi: 10.3389/fphys.2022.963881. eCollection 2022.

Exercise metabolomics in pulmonary arterial hypertension: Where pulmonary vascular metabolism meets exercise physiology

Michael H Lee  1 , Thaís C F Menezes  2 , Julie A Reisz  3 , Eloara V M Ferreira  2 , Brian B Graham  1 , Rudolf K F Oliveira  2
Affiliations
Review

Exercise metabolomics in pulmonary arterial hypertension: Where pulmonary vascular metabolism meets exercise physiology

Michael H Lee et al. Front Physiol. .

Abstract

Pulmonary arterial hypertension is an incurable disease marked by dysregulated metabolism, both at the cellular level in the pulmonary vasculature, and at the whole-body level characterized by impaired exercise oxygen consumption. Though both altered pulmonary vascular metabolism and abnormal exercise physiology are key markers of disease severity and pulmonary arterial remodeling, their precise interactions are relatively unknown. Herein we review normal pulmonary vascular physiology and the current understanding of pulmonary vascular cell metabolism and cardiopulmonary response to exercise in Pulmonary arterial hypertension. We additionally introduce a newly developed international collaborative effort aimed at quantifying exercise-induced changes in pulmonary vascular metabolism, which will inform about underlying pathophysiology and clinical management. We support our investigative approach by presenting preliminary data and discuss potential future applications of our research platform.

Keywords: exercise physiology; metabolomics; pulmonary arterial hypertension; pulmonary hypertension; pulmonary vascular metabolism; pulmonary vascular reserve; right heart catheterization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Exercise-induced changes in lactate (A) and glucose (B) levels from rest to peak exercise, measured from pulmonary artery catheters in 12 patients with systemic sclerosis-associated pulmonary arterial hypertension. ***p = 0.0005 (Wilcoxon matched-pairs signed rank test).
FIGURE 2
FIGURE 2
Correlations between right ventricular stroke work index (RV_SWI) and pulmonary artery glucose levels, measured at rest (A) and peak exercise (B) in 12 patients with systemic sclerosis-associated pulmonary arterial hypertension.
FIGURE 3
FIGURE 3
Invasive exercise protocol. 1Collected from the pulmonary artery catheter and from the radial artery catheter. 2RHC measurements include heart rate, blood pressure, right atrial pressure, pulmonary arterial pressure, pulmonary arterial wedge pressure, and cardiac output. 3Study length varies on an individual basis, until exhaustion. RHC right heart catheterization; SaO2 radial artery O2 saturation; SvO2 mixed-venous O2 saturation; workload in Watts.
See this image and copyright information in PMC

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