Contrasting Cardiopulmonary Responses to Incremental Exercise in Patients with Schistosomiasis-Associated and Idiopathic Pulmonary Arterial Hypertension with Similar Resting Hemodynamic Impairment

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dc.contributor.author Valois, Fabricio Martins [UNIFESP]
dc.contributor.author Nery, Luiz Eduardo [UNIFESP]
dc.contributor.author Ramos, Roberta Pulcheri [UNIFESP]
dc.contributor.author Ferreira, Eloara Vieira Machado [UNIFESP]
dc.contributor.author Silva, Celia Camelo [UNIFESP]
dc.contributor.author Neder, Jose Alberto [UNIFESP]
dc.contributor.author Ota-Arakaki, Jaquelina Sonoe [UNIFESP]
dc.date.accessioned 2016-01-24T14:35:18Z
dc.date.available 2016-01-24T14:35:18Z
dc.date.issued 2014-02-03
dc.identifier http://dx.doi.org/10.1371/journal.pone.0087699
dc.identifier.citation Plos One. San Francisco: Public Library Science, v. 9, n. 2, 6 p., 2014.
dc.identifier.issn 1932-6203
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/37426
dc.description.abstract It has been reported that schistosomiasis-associated PAH (Sch-PAH) has a more benign clinical course compared with idiopathic PAH (IPAH). We therefore hypothesized that Sch-PAH subjects would present with less impaired cardiopulmonary and metabolic responses to exercise than IPAH patients, even with similar resting pulmonary hemodynamic abnormalities. the aim of this study was to contrast physiologic responses to incremental exercise on cycle ergometer between subjects with Sch-PAH and IPAH. We performed incremental cardiopulmonary exercise tests (CPET) in subjects newly diagnosed with IPAH (n = 9) and Sch-PAH (n = 8), within 1 month of the hemodynamic study and before the initiation of specific therapy for PAH. There were no significant between-group differences in cardiac index, pulmonary vascular resistance or mean pulmonary artery pressure. However, mean peak oxygen uptake (VO2) was greater in Sch-PAH than IPAH patients (75.5 +/- 21.4 vs 54.1 +/- 16.1% predicted, p = 0.016), as well as the ratio of increase in VO2 to work rate (8.1 +/- 1.0 vs 6.8 +/- 1.8 mL/min/W, p = 0.03). Additionally, the slope of the ventilatory response as a function of CO2 output was lower in Sch-PAH (40.3 +/- 3.9 vs 55.6 +/- 19.8; p = 0.04), and the heart rate response for a given change in VO2 was also diminished in Sch-PAH compared to IPAH (80.1 +/- 20.6 vs 123.0 +/- 39.2 beats/L/min; p = 0.02). in conclusion, Sch-PAH patients had less impaired physiological responses to exercise than IPAH subjects with similar resting hemodynamic dysfunction. Our data suggest a more preserved cardiopulmonary response to exercise in Sch-PAH which might be related to its better clinical course compared to IPAH. en
dc.format.extent 6
dc.language.iso eng
dc.publisher Public Library Science
dc.relation.ispartof Plos One
dc.rights Acesso aberto
dc.title Contrasting Cardiopulmonary Responses to Incremental Exercise in Patients with Schistosomiasis-Associated and Idiopathic Pulmonary Arterial Hypertension with Similar Resting Hemodynamic Impairment en
dc.type Artigo
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Queens Univ
dc.description.affiliation Fed Univ São Paulo UNIFESP, Dept Med, Div Resp Dis, São Paulo, Brazil
dc.description.affiliation Fed Univ São Paulo UNIFESP, Dept Med, Div Cardiol, São Paulo, Brazil
dc.description.affiliation Queens Univ, Dept Med, Div Resp & Crit Care Med, Kingston, ON K7L 3N6, Canada
dc.description.affiliationUnifesp Fed Univ São Paulo UNIFESP, Dept Med, Div Resp Dis, São Paulo, Brazil
dc.description.affiliationUnifesp Fed Univ São Paulo UNIFESP, Dept Med, Div Cardiol, São Paulo, Brazil
dc.identifier.file WOS000330626900102.pdf
dc.identifier.doi 10.1371/journal.pone.0087699
dc.description.source Web of Science
dc.identifier.wos WOS:000330626900102



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