PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension

Cardiopulmonary exercise testing and pulmonary function test are important methods for detecting human cardio-pulmonary function. Whether they could screen vasoresponsiveness in idiopathic pulmonary artery hypertension (IPAH) patients remains undefined. One hundred thirty-two IPAH patients with comp...

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Autores principales:	Ci-Jun Luo, Hong-Ling Qiu, Chang-Wei Wu, Jing He, Ping Yuan, Qin-Hua Zhao, Rong Jiang, Wen-Hui Wu, Su-Gang Gong, Jian Guo, Rui Zhang, Jin-Ming Liu, Lan Wang
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/c8c6effbe62e431095c08b0cc69921a8
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spelling	oai:doaj.org-article:c8c6effbe62e431095c08b0cc69921a82021-12-02T23:33:57ZPeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension2045-894010.1177/20458940211059713https://doaj.org/article/c8c6effbe62e431095c08b0cc69921a82021-12-01T00:00:00Zhttps://doi.org/10.1177/20458940211059713https://doaj.org/toc/2045-8940Cardiopulmonary exercise testing and pulmonary function test are important methods for detecting human cardio-pulmonary function. Whether they could screen vasoresponsiveness in idiopathic pulmonary artery hypertension (IPAH) patients remains undefined. One hundred thirty-two IPAH patients with complete data were retrospectively enrolled. Patients were classified as vasodilator-responsive (VR) group and vasodilator-nonresponsive (VNR) group on the basis of the acute vasodilator test. Pulmonary function test and cardiopulmonary exercise testing were assessed subsequently and all patients were confirmed by right heart catheterization. We analyzed cardiopulmonary exercise testing and pulmonary function test data and derived a prediction rule to screen vasodilator-responsive patients in IPAH. Nineteen of VR-IPAH and 113 of VNR-IPAH patients were retrospectively enrolled. Compared with VNR-IPAH patients, VR-IPAH patients had less severe hemodynamic effects (lower RAP, m PAP, PAWP, and PVR). And VR-IPAH patients had higher anaerobic threshold (AT), peak partial pressure of end-tidal carbon dioxide (P ET CO 2 ), oxygen uptake efficiency (OUEP), and FEV 1 /FVC (P all <0.05), while lower peak partial pressure of end-tidal oxygen (P ET O 2 ) and minute ventilation (VE)/carbon dioxide output (VCO 2 ) slope (P all <0.05). FEV 1 /FVC (Odds Ratio [OR]: 1.14, 95% confidence interval [CI]: 1.02–1.26, P = 0.02) and PeakP ET CO 2 (OR: 1.13, 95% CI: 1.01–1.26, P = 0.04) were independent predictors of VR adjusted for age, sex, and body mass index. A novel formula (=−16.17 + 0.123 × PeakP ET CO 2 + 0.127×FEV 1 /FVC) reached a high area under the curve value of 0.8 (P = 0.003). Combined with these parameters, the optimal cutoff value of this model for detection of VR is −1.06, with a specificity of 91% and sensitivity of 67%. Compared with VNR-IPAH patients, VR-IPAH patients had less severe hemodynamic effects. Higher FEV 1 /FVC and higher peak P ET CO 2 were associated with increased odds for vasoresponsiveness. A novel score combining PeakP ET CO 2 and FEV 1 /FVC provides high specificity to predict VR patients among IPAH.Ci-Jun LuoHong-Ling QiuChang-Wei WuJing HePing YuanQin-Hua ZhaoRong JiangWen-Hui WuSu-Gang GongJian GuoRui ZhangJin-Ming LiuLan WangSAGE PublishingarticleDiseases of the circulatory (Cardiovascular) systemRC666-701Diseases of the respiratory systemRC705-779ENPulmonary Circulation, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the respiratory system RC705-779 Ci-Jun Luo Hong-Ling Qiu Chang-Wei Wu Jing He Ping Yuan Qin-Hua Zhao Rong Jiang Wen-Hui Wu Su-Gang Gong Jian Guo Rui Zhang Jin-Ming Liu Lan Wang PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
description	Cardiopulmonary exercise testing and pulmonary function test are important methods for detecting human cardio-pulmonary function. Whether they could screen vasoresponsiveness in idiopathic pulmonary artery hypertension (IPAH) patients remains undefined. One hundred thirty-two IPAH patients with complete data were retrospectively enrolled. Patients were classified as vasodilator-responsive (VR) group and vasodilator-nonresponsive (VNR) group on the basis of the acute vasodilator test. Pulmonary function test and cardiopulmonary exercise testing were assessed subsequently and all patients were confirmed by right heart catheterization. We analyzed cardiopulmonary exercise testing and pulmonary function test data and derived a prediction rule to screen vasodilator-responsive patients in IPAH. Nineteen of VR-IPAH and 113 of VNR-IPAH patients were retrospectively enrolled. Compared with VNR-IPAH patients, VR-IPAH patients had less severe hemodynamic effects (lower RAP, m PAP, PAWP, and PVR). And VR-IPAH patients had higher anaerobic threshold (AT), peak partial pressure of end-tidal carbon dioxide (P ET CO 2 ), oxygen uptake efficiency (OUEP), and FEV 1 /FVC (P all <0.05), while lower peak partial pressure of end-tidal oxygen (P ET O 2 ) and minute ventilation (VE)/carbon dioxide output (VCO 2 ) slope (P all <0.05). FEV 1 /FVC (Odds Ratio [OR]: 1.14, 95% confidence interval [CI]: 1.02–1.26, P = 0.02) and PeakP ET CO 2 (OR: 1.13, 95% CI: 1.01–1.26, P = 0.04) were independent predictors of VR adjusted for age, sex, and body mass index. A novel formula (=−16.17 + 0.123 × PeakP ET CO 2 + 0.127×FEV 1 /FVC) reached a high area under the curve value of 0.8 (P = 0.003). Combined with these parameters, the optimal cutoff value of this model for detection of VR is −1.06, with a specificity of 91% and sensitivity of 67%. Compared with VNR-IPAH patients, VR-IPAH patients had less severe hemodynamic effects. Higher FEV 1 /FVC and higher peak P ET CO 2 were associated with increased odds for vasoresponsiveness. A novel score combining PeakP ET CO 2 and FEV 1 /FVC provides high specificity to predict VR patients among IPAH.
format	article
author	Ci-Jun Luo Hong-Ling Qiu Chang-Wei Wu Jing He Ping Yuan Qin-Hua Zhao Rong Jiang Wen-Hui Wu Su-Gang Gong Jian Guo Rui Zhang Jin-Ming Liu Lan Wang
author_facet	Ci-Jun Luo Hong-Ling Qiu Chang-Wei Wu Jing He Ping Yuan Qin-Hua Zhao Rong Jiang Wen-Hui Wu Su-Gang Gong Jian Guo Rui Zhang Jin-Ming Liu Lan Wang
author_sort	Ci-Jun Luo
title	PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
title_short	PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
title_full	PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
title_fullStr	PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
title_full_unstemmed	PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
title_sort	peakpco combined with fev1/fvc predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/c8c6effbe62e431095c08b0cc69921a8
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PeakPCO combined with FEV1/FVC predicts vasodilator-responsive patients with idiopathic pulmonary arterial hypertension

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