Peak circulatory power is a strong prognostic factor in patients with idiopathic pulmonary arterial hypertension
Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hyperten...
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| Veröffentlicht in: | Respiratory medicine 2018-02, Vol.135, p.29-34 |
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| creator | Tang, Yi Yao, Lei Liu, Zhihong Xie, Wenlin Ma, Xiuping Luo, Qin Zhao, Zhihui Huang, Zhiwei Gao, Liu Jin, Qi Yu, Xue Xiong, Changming Ni, Xinhai Yan, Yinkun Qi, Wenwei |
| description | Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hypertension (IPAH).
Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation).
One hundred forty patients with IPAH (104 female, mean age: 33 ± 11 years) were studied. During follow-up (mean: 42 ± 14 months), 24 patients died and 1 patient underwent lung transplantation. In the univariate analysis, peak oxygen uptake(VO2), oxygen uptake at anaerobic threshold, ventilation (VE)/carbon dioxide output (VCO2) slope, end-tidal partial pressure of carbon dioxide at anaerobic threshold, peak systolic blood pressure (SBP), the change of SBP, the change of heart rate, peak work rate, peak CircP, pulmonary vascular resistance, cardiac index and World Health Organization functional class were predictive of cardiac events (all P |
| doi_str_mv | 10.1016/j.rmed.2018.01.003 |
| format | Article |
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Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation).
One hundred forty patients with IPAH (104 female, mean age: 33 ± 11 years) were studied. During follow-up (mean: 42 ± 14 months), 24 patients died and 1 patient underwent lung transplantation. In the univariate analysis, peak oxygen uptake(VO2), oxygen uptake at anaerobic threshold, ventilation (VE)/carbon dioxide output (VCO2) slope, end-tidal partial pressure of carbon dioxide at anaerobic threshold, peak systolic blood pressure (SBP), the change of SBP, the change of heart rate, peak work rate, peak CircP, pulmonary vascular resistance, cardiac index and World Health Organization functional class were predictive of cardiac events (all P < .05).In the multivariate analysis, Peak CircP in the fourth model had the highest significance compared with peak VO2 and VE/VCO2 slope in the second and third model (chi-square = 5.26, P < .02, HR: 0.99, 95% CI: 0.99 to 1.00).
Peak CircP, better than peak VO2 and VE/VCO2slope, was a strong predictor of cardiac events among exercise parameters in patients with IPAH.
•Peak Circulatory Power can well represent cardiac function.•Peak Circulatory Power is superior to peak oxygen uptake and ventilation/carbon dioxide output slope in predicting prognosis in patients with IPAH.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2018.01.003</identifier><identifier>PMID: 29414450</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Blood pressure ; Blood Pressure - physiology ; Carbon dioxide ; Carbon Dioxide - metabolism ; Cardiopulmonary exercise testing ; Cardiovascular disease ; China - epidemiology ; ClinicalTrials.gov:NCT02061787 ; Congenital diseases ; Exercise ; Exercise Test - methods ; Familial Primary Pulmonary Hypertension - diagnosis ; Familial Primary Pulmonary Hypertension - mortality ; Familial Primary Pulmonary Hypertension - physiopathology ; Female ; Follow-Up Studies ; Functional morphology ; Gender ; Heart diseases ; Heart failure ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart rate ; Humans ; Hypertension ; Idiopathic pulmonary arterial hypertension ; Lung - blood supply ; Lung - diagnostic imaging ; Lung - physiopathology ; Lung transplantation ; Lung Transplantation - statistics & numerical data ; Male ; Maximum oxygen consumption ; Medical diagnosis ; Medical prognosis ; Middle Aged ; Mortality ; Multivariate analysis ; Oxygen ; Oxygen consumption ; Oxygen Consumption - physiology ; Oxygen uptake ; Partial pressure ; Patients ; Peak circulatory power ; Physical training ; Power ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Pulmonary arteries ; Pulmonary hypertension ; Systematic review ; Transplantation ; Vascular Resistance - physiology ; Ventilation</subject><ispartof>Respiratory medicine, 2018-02, Vol.135, p.29-34</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-5a5518ec14671432fc1d40d03699af4691e1e8f1870bd00be498d9a7e76d85af3</citedby><cites>FETCH-LOGICAL-c428t-5a5518ec14671432fc1d40d03699af4691e1e8f1870bd00be498d9a7e76d85af3</cites><orcidid>0000-0002-3785-1947</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0954611118300040$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29414450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tang, Yi</creatorcontrib><creatorcontrib>Yao, Lei</creatorcontrib><creatorcontrib>Liu, Zhihong</creatorcontrib><creatorcontrib>Xie, Wenlin</creatorcontrib><creatorcontrib>Ma, Xiuping</creatorcontrib><creatorcontrib>Luo, Qin</creatorcontrib><creatorcontrib>Zhao, Zhihui</creatorcontrib><creatorcontrib>Huang, Zhiwei</creatorcontrib><creatorcontrib>Gao, Liu</creatorcontrib><creatorcontrib>Jin, Qi</creatorcontrib><creatorcontrib>Yu, Xue</creatorcontrib><creatorcontrib>Xiong, Changming</creatorcontrib><creatorcontrib>Ni, Xinhai</creatorcontrib><creatorcontrib>Yan, Yinkun</creatorcontrib><creatorcontrib>Qi, Wenwei</creatorcontrib><title>Peak circulatory power is a strong prognostic factor in patients with idiopathic pulmonary arterial hypertension</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hypertension (IPAH).
Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation).
One hundred forty patients with IPAH (104 female, mean age: 33 ± 11 years) were studied. During follow-up (mean: 42 ± 14 months), 24 patients died and 1 patient underwent lung transplantation. In the univariate analysis, peak oxygen uptake(VO2), oxygen uptake at anaerobic threshold, ventilation (VE)/carbon dioxide output (VCO2) slope, end-tidal partial pressure of carbon dioxide at anaerobic threshold, peak systolic blood pressure (SBP), the change of SBP, the change of heart rate, peak work rate, peak CircP, pulmonary vascular resistance, cardiac index and World Health Organization functional class were predictive of cardiac events (all P < .05).In the multivariate analysis, Peak CircP in the fourth model had the highest significance compared with peak VO2 and VE/VCO2 slope in the second and third model (chi-square = 5.26, P < .02, HR: 0.99, 95% CI: 0.99 to 1.00).
Peak CircP, better than peak VO2 and VE/VCO2slope, was a strong predictor of cardiac events among exercise parameters in patients with IPAH.
•Peak Circulatory Power can well represent cardiac function.•Peak Circulatory Power is superior to peak oxygen uptake and ventilation/carbon dioxide output slope in predicting prognosis in patients with IPAH.</description><subject>Adult</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Carbon dioxide</subject><subject>Carbon Dioxide - metabolism</subject><subject>Cardiopulmonary exercise testing</subject><subject>Cardiovascular disease</subject><subject>China - epidemiology</subject><subject>ClinicalTrials.gov:NCT02061787</subject><subject>Congenital diseases</subject><subject>Exercise</subject><subject>Exercise Test - methods</subject><subject>Familial Primary Pulmonary Hypertension - diagnosis</subject><subject>Familial Primary Pulmonary Hypertension - mortality</subject><subject>Familial Primary Pulmonary Hypertension - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Functional morphology</subject><subject>Gender</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Idiopathic pulmonary arterial hypertension</subject><subject>Lung - blood supply</subject><subject>Lung - diagnostic imaging</subject><subject>Lung - physiopathology</subject><subject>Lung transplantation</subject><subject>Lung Transplantation - statistics & numerical data</subject><subject>Male</subject><subject>Maximum oxygen consumption</subject><subject>Medical diagnosis</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Oxygen</subject><subject>Oxygen consumption</subject><subject>Oxygen Consumption - physiology</subject><subject>Oxygen uptake</subject><subject>Partial pressure</subject><subject>Patients</subject><subject>Peak circulatory power</subject><subject>Physical training</subject><subject>Power</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Pulmonary arteries</subject><subject>Pulmonary hypertension</subject><subject>Systematic review</subject><subject>Transplantation</subject><subject>Vascular Resistance - physiology</subject><subject>Ventilation</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kT1vFDEQhi0EIkfgD1AgSzRpdjOz9n5YokFR-JAihQJqy2fP5nzsrRfbmyj_Hp8uaSiobNnPvJqZh7H3CDUCdpf7Oh7I1Q3gUAPWAOIF22ArmkpAJ1-yDahWVh0inrE3Ke0BQEkJr9lZoyRK2cKGLT_I_ObWR7tOJof4yJfwQJH7xA1POYb5ji8x3M0hZW_5aGyBuJ_5YrKnOSf-4POOe-dDedkVZFmnQ5hNSTIxU_Rm4rvHhcp9Tj7Mb9mr0UyJ3j2d5-zXl-ufV9-qm9uv368-31RWNkOuWtO2OJBF2fUoRTNadBIciE4pM8pOISENIw49bB3AlqQanDI99Z0bWjOKc3Zxyi3d_1kpZX3wydI0mZnCmjQqpbpBDD0W9OM_6D6scS7d6Qagb4XAti9Uc6JsDClFGvUS_aHMqRH00Yfe66MPffShAXXxUYo-PEWv2-Pfc8mzgAJ8OgFUdnHvKepky14tOR_JZu2C_1_-X3mNnU8</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Tang, Yi</creator><creator>Yao, Lei</creator><creator>Liu, Zhihong</creator><creator>Xie, Wenlin</creator><creator>Ma, Xiuping</creator><creator>Luo, Qin</creator><creator>Zhao, Zhihui</creator><creator>Huang, Zhiwei</creator><creator>Gao, Liu</creator><creator>Jin, Qi</creator><creator>Yu, Xue</creator><creator>Xiong, Changming</creator><creator>Ni, Xinhai</creator><creator>Yan, Yinkun</creator><creator>Qi, Wenwei</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3785-1947</orcidid></search><sort><creationdate>201802</creationdate><title>Peak circulatory power is a strong prognostic factor in patients with idiopathic pulmonary arterial hypertension</title><author>Tang, Yi ; Yao, Lei ; Liu, Zhihong ; Xie, Wenlin ; Ma, Xiuping ; Luo, Qin ; Zhao, Zhihui ; Huang, Zhiwei ; Gao, Liu ; Jin, Qi ; Yu, Xue ; Xiong, Changming ; Ni, Xinhai ; Yan, Yinkun ; Qi, Wenwei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-5a5518ec14671432fc1d40d03699af4691e1e8f1870bd00be498d9a7e76d85af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Carbon dioxide</topic><topic>Carbon Dioxide - metabolism</topic><topic>Cardiopulmonary exercise testing</topic><topic>Cardiovascular disease</topic><topic>China - epidemiology</topic><topic>ClinicalTrials.gov:NCT02061787</topic><topic>Congenital diseases</topic><topic>Exercise</topic><topic>Exercise Test - methods</topic><topic>Familial Primary Pulmonary Hypertension - diagnosis</topic><topic>Familial Primary Pulmonary Hypertension - mortality</topic><topic>Familial Primary Pulmonary Hypertension - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Functional morphology</topic><topic>Gender</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Idiopathic pulmonary arterial hypertension</topic><topic>Lung - blood supply</topic><topic>Lung - diagnostic imaging</topic><topic>Lung - physiopathology</topic><topic>Lung transplantation</topic><topic>Lung Transplantation - statistics & numerical data</topic><topic>Male</topic><topic>Maximum oxygen consumption</topic><topic>Medical diagnosis</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Oxygen</topic><topic>Oxygen consumption</topic><topic>Oxygen Consumption - physiology</topic><topic>Oxygen uptake</topic><topic>Partial pressure</topic><topic>Patients</topic><topic>Peak circulatory power</topic><topic>Physical training</topic><topic>Power</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Pulmonary arteries</topic><topic>Pulmonary hypertension</topic><topic>Systematic review</topic><topic>Transplantation</topic><topic>Vascular Resistance - physiology</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tang, Yi</creatorcontrib><creatorcontrib>Yao, Lei</creatorcontrib><creatorcontrib>Liu, Zhihong</creatorcontrib><creatorcontrib>Xie, Wenlin</creatorcontrib><creatorcontrib>Ma, Xiuping</creatorcontrib><creatorcontrib>Luo, Qin</creatorcontrib><creatorcontrib>Zhao, Zhihui</creatorcontrib><creatorcontrib>Huang, Zhiwei</creatorcontrib><creatorcontrib>Gao, Liu</creatorcontrib><creatorcontrib>Jin, Qi</creatorcontrib><creatorcontrib>Yu, Xue</creatorcontrib><creatorcontrib>Xiong, Changming</creatorcontrib><creatorcontrib>Ni, Xinhai</creatorcontrib><creatorcontrib>Yan, Yinkun</creatorcontrib><creatorcontrib>Qi, Wenwei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tang, Yi</au><au>Yao, Lei</au><au>Liu, Zhihong</au><au>Xie, Wenlin</au><au>Ma, Xiuping</au><au>Luo, Qin</au><au>Zhao, Zhihui</au><au>Huang, Zhiwei</au><au>Gao, Liu</au><au>Jin, Qi</au><au>Yu, Xue</au><au>Xiong, Changming</au><au>Ni, Xinhai</au><au>Yan, Yinkun</au><au>Qi, Wenwei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peak circulatory power is a strong prognostic factor in patients with idiopathic pulmonary arterial hypertension</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2018-02</date><risdate>2018</risdate><volume>135</volume><spage>29</spage><epage>34</epage><pages>29-34</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Studies have shown that peak circulatory power (peak CircP; peak oxygen uptake × peak systolic blood pressure) is a variable predictor of prognosis in patients with left heart failure. It remains unknown whether peak CircP also predicts outcome in patients with idiopathic pulmonary arterial hypertension (IPAH).
Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing (CPET) from 1 January 2011 to 1 January 2014 in Fuwai Hospital were prospectively enrolled and followed for up to 66 months for cardiac events (mortality and lung transplantation).
One hundred forty patients with IPAH (104 female, mean age: 33 ± 11 years) were studied. During follow-up (mean: 42 ± 14 months), 24 patients died and 1 patient underwent lung transplantation. In the univariate analysis, peak oxygen uptake(VO2), oxygen uptake at anaerobic threshold, ventilation (VE)/carbon dioxide output (VCO2) slope, end-tidal partial pressure of carbon dioxide at anaerobic threshold, peak systolic blood pressure (SBP), the change of SBP, the change of heart rate, peak work rate, peak CircP, pulmonary vascular resistance, cardiac index and World Health Organization functional class were predictive of cardiac events (all P < .05).In the multivariate analysis, Peak CircP in the fourth model had the highest significance compared with peak VO2 and VE/VCO2 slope in the second and third model (chi-square = 5.26, P < .02, HR: 0.99, 95% CI: 0.99 to 1.00).
Peak CircP, better than peak VO2 and VE/VCO2slope, was a strong predictor of cardiac events among exercise parameters in patients with IPAH.
•Peak Circulatory Power can well represent cardiac function.•Peak Circulatory Power is superior to peak oxygen uptake and ventilation/carbon dioxide output slope in predicting prognosis in patients with IPAH.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29414450</pmid><doi>10.1016/j.rmed.2018.01.003</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3785-1947</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Blood pressure Blood Pressure - physiology Carbon dioxide Carbon Dioxide - metabolism Cardiopulmonary exercise testing Cardiovascular disease China - epidemiology ClinicalTrials.gov:NCT02061787 Congenital diseases Exercise Exercise Test - methods Familial Primary Pulmonary Hypertension - diagnosis Familial Primary Pulmonary Hypertension - mortality Familial Primary Pulmonary Hypertension - physiopathology Female Follow-Up Studies Functional morphology Gender Heart diseases Heart failure Heart Failure - mortality Heart Failure - physiopathology Heart rate Humans Hypertension Idiopathic pulmonary arterial hypertension Lung - blood supply Lung - diagnostic imaging Lung - physiopathology Lung transplantation Lung Transplantation - statistics & numerical data Male Maximum oxygen consumption Medical diagnosis Medical prognosis Middle Aged Mortality Multivariate analysis Oxygen Oxygen consumption Oxygen Consumption - physiology Oxygen uptake Partial pressure Patients Peak circulatory power Physical training Power Predictive Value of Tests Prognosis Prospective Studies Pulmonary arteries Pulmonary hypertension Systematic review Transplantation Vascular Resistance - physiology Ventilation |
| title | Peak circulatory power is a strong prognostic factor in patients with idiopathic pulmonary arterial hypertension |
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