PMID- 33879384
OWN - NLM
STAT- MEDLINE
DCOM- 20220131
LR  - 20220131
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 40
IP  - 7
DP  - 2021 Jul
TI  - Factors contributing to exercise capacity in chronic thromboembolic pulmonary 
      hypertension with near-normal hemodynamics.
PG  - 677-686
LID - S1053-2498(21)02222-1 [pii]
LID - 10.1016/j.healun.2021.03.003 [doi]
AB  - BACKGROUND: Despite improved survival for patients with chronic thromboembolic 
      pulmonary hypertension (CTEPH) due to progressive medical and interventional 
      treatment, impaired exercise capacity remains common due to poorly understood 
      mechanisms. We aimed to clarify the exercise capacity of CTEPH patients with 
      near-normal pulmonary hemodynamics and evaluate its determinants among the 
      hemodynamic, peripheral (e.g., oxygen use by the peripheral tissues), and 
      muscular (e.g., skeletal muscle strength) factors. METHODS: Three hundred and 
      twenty-nine patients with CTEPH (mean age, 63 +/- 12 years; men/women, 73/256) with 
      a near-normal mean pulmonary artery pressure (</=30 mm Hg) at rest were enrolled. 
      We assessed exercise capacity by peak oxygen consumption (peak VO(2)) using 
      cardiopulmonary exercise testing with a right heart catheter. We also measured 
      the 6-minute walk distance (6MWD) and quadriceps muscle strength. RESULTS: The 
      mean pulmonary artery pressure was 19 +/- 4 mmHg and mean cardiac output was 4.8 +/- 
      1.5 L/min at rest. The mean 6MWD was 444 +/- 101 m, while the mean peak VO(2) was 
      14.4 +/- 3.9 mL/min/kg. A multivariate model that predicted 6MWD included 
      quadriceps strength (beta = 0.45, p < 0.001) and peak arterial venous oxygen 
      difference (beta = 0.29, p < 0.001). In contrast, the peak VO(2) was best correlated 
      with mPAP-CO slope (beta = -0.30, p < 0.001), followed by quadriceps strength and 
      peak arterial venous oxygen difference. CONCLUSIONS: The 6MWD performance may be 
      significantly influenced by peripheral oxygen use and muscular factors, while 
      peak VO(2) is influenced by hemodynamic and peripheral factors in CTEPH patients 
      with near-normal hemodynamics.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Tobita, Kazuki
AU  - Tobita K
AD  - Department of Rehabilitation, Kyorin University Hospital, Tokyo, Japan.
FAU - Goda, Ayumi
AU  - Goda A
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan. 
      Electronic address: ayumix34@yahoo.co.jp.
FAU - Nishida, Yuichiro
AU  - Nishida Y
AD  - Department of Rehabilitation, Kyorin University Hospital, Tokyo, Japan.
FAU - Takeuchi, Kaori
AU  - Takeuchi K
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
FAU - Kikuchi, Hanako
AU  - Kikuchi H
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
FAU - Inami, Takumi
AU  - Inami T
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
FAU - Kohno, Takashi
AU  - Kohno T
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
FAU - Yamada, Shin
AU  - Yamada S
AD  - Department of Rehabilitation, Kyorin University Hospital, Tokyo, Japan.
FAU - Soejima, Kyoko
AU  - Soejima K
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
FAU - Satoh, Toru
AU  - Satoh T
AD  - Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20210305
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Exercise Test
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Hypertension, Pulmonary/complications/*physiopathology
MH  - Japan/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/*physiopathology
MH  - Pulmonary Embolism/*etiology/mortality/physiopathology
MH  - Retrospective Studies
MH  - Survival Rate/trends
OTO - NOTNLM
OT  - Pulmonary hypertension
OT  - exercise capacity
OT  - muscle strength
COIS- Financial conflict of interest statement The authors declare no potential 
      conflicts of interest related to any company or organization whose products or 
      services are discussed in this article.
EDAT- 2021/04/22 06:00
MHDA- 2022/02/01 06:00
CRDT- 2021/04/21 05:51
PHST- 2020/09/06 00:00 [received]
PHST- 2021/02/15 00:00 [revised]
PHST- 2021/03/02 00:00 [accepted]
PHST- 2021/04/22 06:00 [pubmed]
PHST- 2022/02/01 06:00 [medline]
PHST- 2021/04/21 05:51 [entrez]
AID - S1053-2498(21)02222-1 [pii]
AID - 10.1016/j.healun.2021.03.003 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2021 Jul;40(7):677-686. doi: 
      10.1016/j.healun.2021.03.003. Epub 2021 Mar 5.