Pulmonary hypertension is associated with impaired exercise performance in patients with systemic sclerosis.
OBJECTIVE
The aim of this study was to evaluate the exercise tolerance by expired gas analysis during stress test in patients with Systemic Sclerosis (SSc).


METHODS
Eighteen women (mean age 48.56+/-12.48 years) affected by SSc were studied. A complete echocardiographic examination including pulmonary artery systolic pressure estimation, pulmonary function tests, diffusion lung capacity for carbon monoxide (DLCO), and exercise test were performed. During exercise, breath-by-breath expired gas analysis was performed.


RESULTS
Seven patients (39%) had baseline pulmonary systolic hypertension (group A) and 11 patients (61%) did not (group B). Six patients had reduced DLCO values. Both maximal oxygen consumption (VO2max) and anaerobic threshold (VO2AT) values were markedly decreased compared to the predicted values. Seven of 18 patients were unable to complete a maximal exercise (5 of whom affected by pulmonary systolic hypertension). Group A patients showed reduced VO2max, VO2AT, and O2 pulse compared with patients with group B patients (p=0.004, 0.017, and 0.013, respectively); VO2max, VO2AT and O2 pulse were significantly correlated to baseline pulmonary artery systolic pressure.


CONCLUSIONS
An exercise intolerance in patients affected by SSc is present. Impairment of exercise performance is associated with pulmonary hypertension.
Morelli
S
S
Cattedra di I Clinica Medica, Università La Sapienza, Rome, Italy. smorelli@uniroma1.it
Ferrante
L
L
Sgreccia
A
A
Eleuteri
M L
ML
Perrone
C
C
De Marzio
P
P
Balsano
F
F
D000328:Adult; D001794:Blood Pressure; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D008176:Lung Volume Measurements; D008875:Middle Aged; D010101:Oxygen Consumption; D011651:Pulmonary Artery; D011928:Raynaud Disease / Q000150:complications / Q000188:drug therapy; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology*; D012867:Skin / Q000473:pathology; D016277:Ventricular Function, Left