Experience with exercise right heart catheterization in the diagnosis of pulmonary hypertension: a retrospective study

  • Stephan Keusch Clinic of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
  • Anina Bucher Clinic of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
  • Séverine Müller-Mottet Clinic of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
  • Elisabeth Hasler Clinic of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
  • Marco Maggiorini Clinic for Internal Medicine, University Hospital of Zurich, Zurich, Italy.
  • Rudolf Speich Clinic for Internal Medicine, University Hospital of Zurich, Zurich, Switzerland.
  • Silvia Ulrich | silvia.ulrich@usz.ch Clinic of Pulmonology, University Hospital of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, Zurich, Switzerland.

Abstract

Background: Data on exercise pulmonary hemodynamics in healthy people and patients with pulmonary hypertension (PH) are rare. We analyzed exercise right heart catheterization (RHC) data in a symptomatic collective referred with suspected PH to characterize the differential response by diagnostic groups, to correlate resting with exercise hemodynamics, and to evaluate safety.

Methods: This is a retrospective single-center study reviewing data from patients in whom an exercise RHC was performed between January 2006 and January 2013. Patients with follow-up RHC under PH -therapy were excluded.

Results: Data from 101 patients were analyzed, none of them had an adverse event. In 35% we detected a resting PH (27.8% precapillary, 6.9% postcapillary). Exercise PH (mean pulmonary arterial pressure (mPAP) >30 mmHg at exercise) was found in 38.6%, whereas in 25.7% PH was excluded. We found a remarkable number of exercise PH in scleroderma patients, the majority being postcapillary. 83% of patients with mPAP-values between 20 and 24.9 mmHg at rest had exercise PH. Patients with resting PH had worse hemodynamics and were older compared with exercise PH ones.

Conclusion: In this real-life experience in symptomatic patients undergoing exercise RHC for suspected PH, we found that exercise RHC is safe. The facts that the vast majority of patients with mPAP-values between 20 and 24.9 mmHg at rest had exercise PH and the older age of patients with resting PH may indicate that exercise PH is a precursor of resting PH. Whether earlier treatment start in patients with exercise PH would stabilize the disease should be addressed in future studies.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.
Published
2014-10-15
Info
Issue
Section
Original Research Articles
Keywords:
Exercise, Pulmonary arterial hypertension, Pulmonary hypertension, Right heart catheterization
Statistics
  • Abstract views: 85

  • PDF: 74
  • HTML: 9
How to Cite
Keusch, S., Bucher, A., Müller-Mottet, S., Hasler, E., Maggiorini, M., Speich, R., & Ulrich, S. (2014). Experience with exercise right heart catheterization in the diagnosis of pulmonary hypertension: a retrospective study. Multidisciplinary Respiratory Medicine, 9(1). https://doi.org/10.4081/mrm.2014.386