PMID- 24905576
OWN - NLM
STAT- MEDLINE
DCOM- 20150130
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 6
DP  - 2014
TI  - Usefulness of decrease in oxygen uptake efficiency to identify gas exchange 
      abnormality in patients with idiopathic pulmonary arterial hypertension.
PG  - e98889
LID - 10.1371/journal.pone.0098889 [doi]
LID - e98889
AB  - BACKGROUND: Decline in oxygen uptake efficiency (OUE), especially during 
      exercise, is found in patients with chronic heart failure. In this study we aimed 
      to test the validity and usefulness of OUE in evaluating gas exchange abnormality 
      of patients with idiopathic pulmonary arterial hypertension (IPAH). METHODS: We 
      retrospectively investigated the cardiopulmonary exercise test (CPET) with gas 
      exchange measurements in 32 patients with confirmed IPAH. All patients also had 
      resting hemodynamic measurements and pulmonary function test (PFT). Sixteen 
      healthy subjects, matched by age, sex, and body size were used as controls, also 
      had CPET and PFT measurements. RESULTS: In IPAH patients, the magnitude of 
      absolute and percentage of predicted (%pred) oxygen uptake efficiency slope 
      (OUES) and oxygen uptake efficiency plateau (OUEP), as well as several other CPET 
      parameters, were strikingly worse than healthy subjects (P<0.0001). Pattern of 
      changes in OUE in patients is similar to that in controls, In IPAH patients, OUE 
      values at rest, warming up, anaerobic threshold and peak exercise were all 
      significantly lower than in normal (P<0.0001). OUEP%pred, better than OUES%pred, 
      correlated significantly with New York Heart Association (NYHA) functional Class 
      (r = -0.724, P<0.005), Total Pulmonary Vascular Resistance (TPVR) (r = -0.694, 
      P<0.005), diffusing capacity for carbon monoxide (DLCO) (r = 0.577, P<0.05), and 
      the lowest ventilation versus CO2 output ratio during exercise (LowestV E/V CO2) 
      (r = -0.902, P<0.0001). In addition, the coefficient of variation (COV) of OUEP 
      was lower (20.9%) markedly than OUES (34.3%) (P<0.0001). CONCLUSIONS: In patients 
      with IPAH, OUES and OUEP are both significantly lower than the healthy subjects. 
      OUEP is a better physiological parameter than OUES in evaluating the gas exchange 
      abnormality of patients with IPAH.
FAU - Tan, Xiaoyue
AU  - Tan X
AD  - Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China; State Key Laboratory of Cardiovascular 
      Disease, Heart-Lung Function Testing Center, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, China.
FAU - Yang, Wenlan
AU  - Yang W
AD  - Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China.
FAU - Guo, Jian
AU  - Guo J
AD  - Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China.
FAU - Zhang, Yan
AU  - Zhang Y
AD  - Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China; Respiratory Division, Hangzhou, Zhejiang 
      Provincial Hospital of traditional Chinese Medicine, The First Affiliated 
      Hospital of Zhejiang Chinese Medicine University, Hangzhou, China.
FAU - Wu, Changwei
AU  - Wu C
AD  - Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China.
FAU - Sapkota, Rikesh
AU  - Sapkota R
AD  - Department of Pulmonary Circulation, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China.
FAU - Kushwaha, Shailendra Prasad
AU  - Kushwaha SP
AD  - Department of Pulmonary Circulation, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China.
FAU - Gong, Sugang
AU  - Gong S
AD  - Department of Pulmonary Circulation, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China.
FAU - Sun, Xingguo
AU  - Sun X
AD  - State Key Laboratory of Cardiovascular Disease, Heart-Lung Function Testing 
      Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
FAU - Liu, Jinming
AU  - Liu J
AD  - Department of Pulmonary Function Test, Shanghai Pulmonary Hospital Affiliated to 
      Tongji University, Shanghai, China; Department of Pulmonary Circulation, Shanghai 
      Pulmonary Hospital Affiliated to Tongji University, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140606
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Cardiac Output
MH  - Case-Control Studies
MH  - Exercise/physiology
MH  - Familial Primary Pulmonary Hypertension/*metabolism/physiopathology
MH  - Female
MH  - Humans
MH  - Male
MH  - *Oxygen Consumption
MH  - *Pulmonary Gas Exchange
MH  - Pulmonary Ventilation
MH  - Rest/physiology
MH  - Retrospective Studies
PMC - PMC4048265
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2014/06/07 06:00
MHDA- 2015/01/31 06:00
PMCR- 2014/06/06
CRDT- 2014/06/07 06:00
PHST- 2013/12/13 00:00 [received]
PHST- 2014/05/08 00:00 [accepted]
PHST- 2014/06/07 06:00 [entrez]
PHST- 2014/06/07 06:00 [pubmed]
PHST- 2015/01/31 06:00 [medline]
PHST- 2014/06/06 00:00 [pmc-release]
AID - PONE-D-13-52534 [pii]
AID - 10.1371/journal.pone.0098889 [doi]
PST - epublish
SO  - PLoS One. 2014 Jun 6;9(6):e98889. doi: 10.1371/journal.pone.0098889. eCollection 
      2014.