Journal Article

Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis – The Predictive Value of Exercise Capacity and Gas Exchange Efficiency

Obst, Anne, Gläser, Sven, Grieger, Anita, Bollmann, Tom, Felix, Stephan B., Bruch, Leonhard, Schäper, Christoph, Koch, Beate, Warnke, Christian, Halank, Michael, Ewert, Ralf, Henkel, Beate

2013

Overview

Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 135 patients [82 males; median age of 64 (56; 72 years)] with IPF had pulmonary hypertension as assessed by right heart catheterization [median mean pulmonary arterial pressure 34 (27; 43) mmHg]. The presence of pulmonary hypertension was best predicted by gas exchange efficiency for carbon dioxide (cut off ≥152% predicted; area under the curve 0.94) and peak oxygen uptake (≤56% predicted; 0.83), followed by diffusing capacity. Resting lung volumes did not predict pulmonary hypertension. Survival was best predicted by the presence of pulmonary hypertension, followed by peak oxygen uptake [HR 0.96 (0.93; 0.98)]. Pulmonary hypertension in IPF patients is best predicted by gas exchange efficiency during exercise and peak oxygen uptake. In addition to invasively measured pulmonary arterial pressure, oxygen uptake at peak exercise predicts survival in this patient population.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Blood pressure / Carbon dioxide / Carbon dioxide exchange / Carbon monoxide / Cardiology / Care and treatment / Catheterization / Diagnosis / Diagnostic systems / Dyspnea / Efficiency / Ethics / Exercise Tolerance / Female / Fibrosis / Gas exchange / Health aspects / Heart / Humans / Hypertension / Hypertension, Pulmonary - diagnosis / Hypertension, Pulmonary - mortality / Hypertension, Pulmonary - physiopathology / Idiopathic Pulmonary Fibrosis - mortality / Idiopathic Pulmonary Fibrosis - physiopathology / Infectious diseases / Intensive care / Internal medicine / Intubation / Kaplan-Meier Estimate / Life expectancy / Lung diseases / Male / Males / Medical diagnosis / Medical research / Medicine / Middle Aged / Mortality / Multivariate Analysis / Oxygen / Oxygen uptake / Patients / Prognosis / Pulmonary arteries / Pulmonary fibrosis / Pulmonary function tests / Pulmonary Gas Exchange / Pulmonary hypertension / Respiratory function / Respiratory tract diseases / Survival