Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Disclaimer
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Huez, S.
Right arrow Articles by Naeije, R.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Huez, S.
Right arrow Articles by Naeije, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Exercise stress tests for detection and evaluation of pulmonary hypertension

Sandrine Huez1,2,* and Robert Naeije1,2

1 Department of Cardiology, Erasme University Hospital, Brussels, Belgium
2 Department of Pathophysiology, Faculty of Medicine of the Free University of Brussels, Erasme Campus, CP 604, 808, Lennik Road, B-1070 Brussels, Belgium

* Corresponding author. Tel: +32 2 5556363. E-mail address: shuez{at}ulb.ac.be

The use of an exercise stress test in the diagnosis or evaluation of pulmonary hypertension rests on the assumption that multipoint mean pulmonary artery pressure (mPpa)–flow (Q) plots are superior to isolated pulmonary vascular resistance determinations for the evaluation of the functional state of the pulmonary circulation. A multipoint mPpa–Q relationship is best described by a linear approximation and, as such, characterized by an extrapolated pressure intercept and by a slope. Both are dependent on the method used to increase flow. The slope is higher and the pressure intercept lower when exercise is used to increase flow, rather than unilateral pulmonary artery balloon occlusion or low-dose dobutamine. This is because of exercise-induced pulmonary vasoconstriction. The steepest slopes, i.e. the highest pressures at a given flow, are obtained by resistive exercise (handgrip) when compared with dynamic exercise (cycling) because of systemic vascular resistance and intrathoracic pressure changes. Since systolic, diastolic, and mean pulmonary artery pressures are tightly correlated and since in experienced hands, systolic pulmonary artery pressures and cardiac output are reliably measured using Doppler echocardiography, mPpa–Q lines can be obtained non-invasively. The exercise stress test for non-invasive diagnosis of pulmonary hypertension may be particularly useful for the detection of early disease and for more accurate quantification of pulmonary vascular changes induced by disease progression and/or therapeutic interventions.

Key Words: Pulmonary vascular resistance • Pulmonary arterial pressure–flow relationships • Pulmonary hypertension • Exercise • Echocardiography • Dobutamine


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.