Use of Noninvasive Gas Exchange to Track pulmonary Vascular Responses to exercise in Heart Failure

We determined whether a non-invasive gas exchange based estimate of pulmonary vascular (PV) capacitance [PV CAP = stroke volume (SV) x pulmonary arterial pressure (Ppa)] (GX CAP ) tracked the PV response to exercise in heart-failure (HF) patients. Pulmonary wedge pressure (Ppw), Ppa, PV resistance (...

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Bibliographic Details
Main Authors: Bryan J. Taylor, Thomas P. Olson, Chul-Ho-Kim, Dean Maccarter, Bruce D. Johnson
Format: Article
Language:English
Published: SAGE Publishing 2013-01-01
Series:Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine
Online Access:https://doi.org/10.4137/CCRPM.S12178
Description
Summary:We determined whether a non-invasive gas exchange based estimate of pulmonary vascular (PV) capacitance [PV CAP = stroke volume (SV) x pulmonary arterial pressure (Ppa)] (GX CAP ) tracked the PV response to exercise in heart-failure (HF) patients. Pulmonary wedge pressure (Ppw), Ppa, PV resistance (PVR), and gas exchange were measured simultaneously during cycle exercise in 42 HF patients undergoing right-heart catheterization. During exercise, P ET CO 2 and V E /VCO 2 were related to each other ( r = -0.93, P < 0.01) and similarly related to mean Ppa (mPpa) ( r = -0.39 and 0.36; P < 0.05); P ET CO 2 was subsequently used as a metric of mPpa. Oxygen pulse (O 2 pulse) tracked the SV response to exercise (r = 0.91, P < 0.01). Thus, GX CAP was calculated as O 2 pulse x P ET CO 2 . During exercise, invasively determined PV CAP and non-invasive GX CAP were related (r = 0.86, P < 0.01), and GX CAP correlated with mPpa and PVR (r = -0.46 and -0.54; P < 0.01). In conclusion, noninvasive gas exchange measures may represent a simple way to track the PV response to exercise in HF.
ISSN:1179-5484