Gas exchange responses during 6-min walk test in patients with pulmonary arterial hypertension

Journal article

Morris, Norman R., Seale, Helen, Harris, Julie, Hall, Kathleen, Lin, Aaron C. W. and Kermeen, Fiona. (2017). Gas exchange responses during 6-min walk test in patients with pulmonary arterial hypertension. Respirology. 22(1), pp. 165 - 171. https://doi.org/10.1111/resp.12868
AuthorsMorris, Norman R., Seale, Helen, Harris, Julie, Hall, Kathleen, Lin, Aaron C. W. and Kermeen, Fiona
Abstract

Background and objective The 6‐min walk test (6MWT) is the most widely utilized method of assessing exercise capacity in pulmonary arterial hypertension (PAH). Cardiopulmonary exercise testing has the advantage of providing additional physiological information over 6MWT. The goals of our study were to describe the addition of gas exchange measurements to 6MWT and to determine how these parameters were related to the severity of PAH in three major subgroups of PAH (idiopathic (IPAH), connective tissue disease‐related (CTPAH) and congenital heart disease‐related (CHPAH)). Methods Seventy‐six PAH patients (IPAH, n = 28; CTPAH, n = 24; CHPAH, n = 24) completed the 6MWT with simultaneous gas exchange measurements. The 6‐min walk distance (6MWD), oxygen uptake (urn:x-wiley:resp:media:resp12868:resp12868-math-0001 O2 ), carbon dioxide production (urn:x-wiley:resp:media:resp12868:resp12868-math-0001 CO2 ), oxygen saturation, minute ventilation to carbon dioxide output (urn:x-wiley:resp:media:resp12868:resp12868-math-0001 E/urn:x-wiley:resp:media:resp12868:resp12868-math-0001 CO2 ) and end‐tidal partial pressure for carbon dioxide (PETCO2 ) were compared between subgroups, different functional classes (FCs) and pharmacotherapy. Results Whilst no significant difference in 6MWT was observed, absolute urn:x-wiley:resp:media:resp12868:resp12868-math-0001 O2 and urn:x-wiley:resp:media:resp12868:resp12868-math-0001 CO2 were higher for IPAH (P < 0.05). Differences were removed when urn:x-wiley:resp:media:resp12868:resp12868-math-0001 O2 and urn:x-wiley:resp:media:resp12868:resp12868-math-0001 CO2 were expressed relative to body mass (i.e. mL/kg/min). CHPAH had the most significant desaturation during 6MWT (CPAH: 73 ± 15%; CTPAH: 90 ± 8%, IPAH: 92 ± 8%, P < 0.01). There was no difference in urn:x-wiley:resp:media:resp12868:resp12868-math-0001 E/urn:x-wiley:resp:media:resp12868:resp12868-math-0001 CO2 and PETCO2 between groups; however, New York Health Association (NYHA) FC II performed better than FC III subjects in 6MWT with lower urn:x-wiley:resp:media:resp12868:resp12868-math-0001 E/urn:x-wiley:resp:media:resp12868:resp12868-math-0001 CO2 and higher end‐exercise PETCO2 . Similarly, individuals on more advanced pharmacotherapy (triple therapy vs monotherapy) had poorer gas exchange during exercise. Conclusion Whilst 6MWT and gas exchange did not differentiate between PAH groups, individuals with more severe disease and on more advanced pharmacotherapy had poorer gas exchange during exercise.

Year2017
JournalRespirology
Journal citation22 (1), pp. 165 - 171
PublisherWiley-Blackwell
ISSN1323-7799
Digital Object Identifier (DOI)https://doi.org/10.1111/resp.12868
Scopus EID2-s2.0-84992467149
Page range165 - 171
Research GroupSchool of Allied Health
Publisher's version
File Access Level
Controlled
Place of publicationAustralia
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