Lung function and stress echocardiography in pulmonary arterial hypertension: a cross-sectional study
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
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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São Paulo medical journal (Online) |
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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 |
_version_ |
1754209267673464832 |