- 作者：Don Hayes Jr. ; Curt J. Daniels ; Heidi M. Mansour ; Benjamin T. Kopp ; Andrew R. Yates ; Karen S. McCoy ; Alpa V. Patel ; Stephen Kirkby
- 关键词：Cystic fibrosis ; Exercise ; Pulmonary arterial hypertension ; Right heart catheterization
- 刊名：Respiratory Medicine
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：107
- 期：9
- 页码：1365-1369
- 全文大小：708 K
Summary
Background
Although pulmonary arterial hypertension (PAH) is a potential co-morbidity in cystic fibrosis (CF), right heart catheterization (RHC) is not commonly performed in this patient population until referral for lung transplantation.Material and methods
An non-randomized observational pilot study was performed after an exercise protocol with an upright stationary bicycle was added to RHC performed in patients with CF undergoing evaluation for lung transplantation (LT).
Results
Twelve consecutive patients with advanced lung disease due to CF referred for LT completed RHC with exercise protocol. Transthoracic echocardiography (TTE) prior to the RHC did not identify evidence of PAH or significant structural abnormalities; right and left ventricular systolic function were normal. non-randomized RHC in this same cohort found 75 % (9/12) had PAH with an elevation of the mean pulmonary artery pressure (PAP) at rest with a mean (¡ÀSD) of 27.8?¡À?4.9?mmHg that significantly increased during exercise to 47.2?¡À?5.4?mmHg, p?=?0.0025. For the last 6 patients, pulmonary vascular resistance was calculated during exercise, with a significant increase from 3.15?¡À?0.3 to 12.8?¡À?0.6 Wood Units (p?=?0.0313) comparing measurements at rest to exercise.
Conclusion
RHC at rest and during exercise was safely and effectively performed in patients with CF referred for LT. Furthermore, central hemodynamic measurements found significant worsening of PAH during exercise in a small cohort of CF patients with advanced lung disease.