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. 2024 Nov 6;14(4):e70002.
doi: 10.1002/pul2.70002. eCollection 2024 Oct.

Hemodynamic markers independent of pulmonary capillary wedge pressure can discriminate between pre and postcapillary exercise-induced pulmonary hypertension

Margaret Montovano  1 , Paul J Scheel 3rd  1 , Ilton M Cubero Salazar  1 , Paul M Hassoun  2 , Ryan J Tedford  3 , Steven Hsu  1
Affiliations

Hemodynamic markers independent of pulmonary capillary wedge pressure can discriminate between pre and postcapillary exercise-induced pulmonary hypertension

Margaret Montovano et al. Pulm Circ. .

Abstract

The discrimination between pre and postcapillary exercise-induced pulmonary hypertension relies on accurate measurement of pulmonary capillary wedge pressure, which can be unreliable. We found that exercise pulmonary artery compliance and right atrial pressure (AUC 0.88, 0.89, respectively) can differentiate subtypes of exercise-induced pulmonary hypertension in the absence of wedge pressure.

Keywords: exercise; heart failure; hemodynamics; pulmonary hypertension.

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Conflict of interest statement

Dr. Tedford reports no conflicts related to this manuscript. Dr. Tedford is the cochair of the PH due to left heart disease task force for 7th World Symposium on Pulmonary Hypertension and Deputy Editor for the Journal of Heart and Lung Transplantation. He reports general disclosures to include consulting relationships with and receiving honorarium from Abbott, Acorai, Aria CV Inc., Acceleron/Merck, Alleviant, Boston Scientific, Cytokinetics, Edwards LifeSciences, Endotronix, Gradient, Medtronic, Morphic Therapeutics, Restore Medical, and United Therapeutics. Dr. Tedford serves on steering committee for Abbott, Edwards, Endotronix, and Merck as well as a research advisory board for Abiomed. He also does hemodynamic core lab work for Merck. All other authors have no relevant financial disclosures.

Figures

Figure 1
Figure 1
Data graphically depicted as mean ± SD. During exercise, EiHFpEF patients demonstrate disproportionate elevations in both PCWP and RAP, while EiPAH patients demonstrate significant reductions in PAC. * denotes p < 0.05 at peak exercise; † denotes interaction p < 0.05 suggesting a different trend between groups across all exercise stages.
See this image and copyright information in PMC

References

    1. Humbert M, Kovacs G, Hoeper MM. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN‐LUNG). Eur Heart J. 2022;43(38):3618–3731. - PubMed
    1. Ho JE, Zern EK, Lau ES, Wooster L, Bailey CS, Cunningham T, Eisman AS, Hardin KM, Farrell R, Sbarbaro JA, Schoenike MW, Houstis NE, Baggish AL, Shah RV, Nayor M, Malhotra R, Lewis GD. Exercise pulmonary hypertension predicts clinical outcomes in patients with dyspnea on effort. J Am Coll Cardiol. 2020;75(1):17–26. - PMC - PubMed
    1. Douschan P, Avian A, Foris V, Sassmann T, Bachmaier G, Rosenstock P, Zeder K, Olschewski H, Kovacs G. Prognostic value of exercise as compared to resting pulmonary hemodynamics in patients with normal or mildly elevated pulmonary arterial pressure. Am J Respir Crit Care Med. 2022;206(11):1418–1423. - PMC - PubMed
    1. Lau EMT, Godinas L, Sitbon O, Montani D, Savale L, Jaïs X, Lador F, Gunther S, Celermajer DS, Simonneau G, Humbert M, Chemla D, Herve P. Resting pulmonary artery pressure of 21–24 mmHg predicts abnormal exercise haemodynamics. Eur Respir J. 2016;47(5):1436–1444. - PubMed
    1. Jain CC, Borlaug BA. Performance and interpretation of invasive hemodynamic exercise testing. Chest. 2020;158(5):2119–2129. - PMC - PubMed

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