Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study

Detalhes bibliográficos
Autor(a) principal: de Almeida,Guilherme Casagrande
Data de Publicação: 2021
Outros Autores: Pereira,Mônica Corso, Moreira,Marcos Mello, Souza,José Roberto Matos, Paschoal,Ilma Aparecida
Tipo de documento: Artigo
Idioma: eng
Título da fonte: São Paulo medical journal (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000500505
Resumo: ABSTRACT BACKGROUND: The mechanism of exercise limitation in idiopathic pulmonary arterial hypertension (IPAH) is not fully understood. The role of hemodynamic alterations is well recognized, but mechanical, ventilatory and gasometric factors may also contribute to reduction of exercise capacity in these individuals. OBJECTIVE: To investigate whether there is an association between ventilatory pattern and stress Doppler echocardiography (SDE) variables in IPAH patients. DESIGN AND SETTING: Single-center prospective study conducted in a Brazilian university hospital. METHODS: We included 14 stable IPAH patients and 14 age and sex-matched controls. Volumetric capnography (VCap), spirometry, six-minute walk test and SDE were performed on both the patients and the control subjects. Arterial blood gases were collected only from the patients. The IPAH patients and control subjects were compared with regard to the abovementioned variables. RESULTS: The mean age of the patients was 38.4 years, and 78.6% were women. The patients showed hypocapnia, and in spirometry 42.9% presented forced vital capacity (FVC) below the lower limit of normality. In VCap, IPAH patients had higher respiratory rates (RR) and lower elimination of CO2 in each breath. There was a significant correlation between reduced FVC and the magnitude of increases in tricuspid regurgitation velocity (TRV). In IPAH patients, VCap showed similar tidal volumes and a higher RR, which at least partially explained the hypocapnia. CONCLUSIONS: The patients with IPAH showed hypocapnia, probably related to their higher respiratory rate with preserved tidal volumes; FVC was reduced and this reduction was positively correlated with cardiac output.
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spelling Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional studyHypertension, pulmonaryCapnographyRespiratory function testHypocapniaSix-minute walk testArterial blood gasVolumetric capnographyLung functionABSTRACT BACKGROUND: The mechanism of exercise limitation in idiopathic pulmonary arterial hypertension (IPAH) is not fully understood. The role of hemodynamic alterations is well recognized, but mechanical, ventilatory and gasometric factors may also contribute to reduction of exercise capacity in these individuals. OBJECTIVE: To investigate whether there is an association between ventilatory pattern and stress Doppler echocardiography (SDE) variables in IPAH patients. DESIGN AND SETTING: Single-center prospective study conducted in a Brazilian university hospital. METHODS: We included 14 stable IPAH patients and 14 age and sex-matched controls. Volumetric capnography (VCap), spirometry, six-minute walk test and SDE were performed on both the patients and the control subjects. Arterial blood gases were collected only from the patients. The IPAH patients and control subjects were compared with regard to the abovementioned variables. RESULTS: The mean age of the patients was 38.4 years, and 78.6% were women. The patients showed hypocapnia, and in spirometry 42.9% presented forced vital capacity (FVC) below the lower limit of normality. In VCap, IPAH patients had higher respiratory rates (RR) and lower elimination of CO2 in each breath. There was a significant correlation between reduced FVC and the magnitude of increases in tricuspid regurgitation velocity (TRV). In IPAH patients, VCap showed similar tidal volumes and a higher RR, which at least partially explained the hypocapnia. CONCLUSIONS: The patients with IPAH showed hypocapnia, probably related to their higher respiratory rate with preserved tidal volumes; FVC was reduced and this reduction was positively correlated with cardiac output.Associação Paulista de Medicina - APM2021-05-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000500505Sao Paulo Medical Journal v.139 n.5 2021reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2021.0045.r1.0604221info:eu-repo/semantics/openAccessde Almeida,Guilherme CasagrandePereira,Mônica CorsoMoreira,Marcos MelloSouza,José Roberto MatosPaschoal,Ilma Aparecidaeng2021-08-06T00:00:00Zoai:scielo:S1516-31802021000500505Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2021-08-06T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse
dc.title.none.fl_str_mv Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
title Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
spellingShingle Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
de Almeida,Guilherme Casagrande
Hypertension, pulmonary
Capnography
Respiratory function test
Hypocapnia
Six-minute walk test
Arterial blood gas
Volumetric capnography
Lung function
title_short Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
title_full Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
title_fullStr Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
title_full_unstemmed Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
title_sort Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
author de Almeida,Guilherme Casagrande
author_facet de Almeida,Guilherme Casagrande
Pereira,Mônica Corso
Moreira,Marcos Mello
Souza,José Roberto Matos
Paschoal,Ilma Aparecida
author_role author
author2 Pereira,Mônica Corso
Moreira,Marcos Mello
Souza,José Roberto Matos
Paschoal,Ilma Aparecida
author2_role author
author
author
author
dc.contributor.author.fl_str_mv de Almeida,Guilherme Casagrande
Pereira,Mônica Corso
Moreira,Marcos Mello
Souza,José Roberto Matos
Paschoal,Ilma Aparecida
dc.subject.por.fl_str_mv Hypertension, pulmonary
Capnography
Respiratory function test
Hypocapnia
Six-minute walk test
Arterial blood gas
Volumetric capnography
Lung function
topic Hypertension, pulmonary
Capnography
Respiratory function test
Hypocapnia
Six-minute walk test
Arterial blood gas
Volumetric capnography
Lung function
description ABSTRACT BACKGROUND: The mechanism of exercise limitation in idiopathic pulmonary arterial hypertension (IPAH) is not fully understood. The role of hemodynamic alterations is well recognized, but mechanical, ventilatory and gasometric factors may also contribute to reduction of exercise capacity in these individuals. OBJECTIVE: To investigate whether there is an association between ventilatory pattern and stress Doppler echocardiography (SDE) variables in IPAH patients. DESIGN AND SETTING: Single-center prospective study conducted in a Brazilian university hospital. METHODS: We included 14 stable IPAH patients and 14 age and sex-matched controls. Volumetric capnography (VCap), spirometry, six-minute walk test and SDE were performed on both the patients and the control subjects. Arterial blood gases were collected only from the patients. The IPAH patients and control subjects were compared with regard to the abovementioned variables. RESULTS: The mean age of the patients was 38.4 years, and 78.6% were women. The patients showed hypocapnia, and in spirometry 42.9% presented forced vital capacity (FVC) below the lower limit of normality. In VCap, IPAH patients had higher respiratory rates (RR) and lower elimination of CO2 in each breath. There was a significant correlation between reduced FVC and the magnitude of increases in tricuspid regurgitation velocity (TRV). In IPAH patients, VCap showed similar tidal volumes and a higher RR, which at least partially explained the hypocapnia. CONCLUSIONS: The patients with IPAH showed hypocapnia, probably related to their higher respiratory rate with preserved tidal volumes; FVC was reduced and this reduction was positively correlated with cardiac output.
publishDate 2021
dc.date.none.fl_str_mv 2021-05-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000500505
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802021000500505
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/1516-3180.2021.0045.r1.0604221
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Paulista de Medicina - APM
publisher.none.fl_str_mv Associação Paulista de Medicina - APM
dc.source.none.fl_str_mv Sao Paulo Medical Journal v.139 n.5 2021
reponame:São Paulo medical journal (Online)
instname:Associação Paulista de Medicina
instacron:APM
instname_str Associação Paulista de Medicina
instacron_str APM
institution APM
reponame_str São Paulo medical journal (Online)
collection São Paulo medical journal (Online)
repository.name.fl_str_mv São Paulo medical journal (Online) - Associação Paulista de Medicina
repository.mail.fl_str_mv revistas@apm.org.br
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