title: Hemodynamic ranges during daily activities and exercise testing in patients with pulmonary arterial hypertension.
abstract: BACKGROUND
  In patients with pulmonary arterial hypertension (PAH) the relationship between hemodynamic impairment experienced during daily activity and that during exercise testing is not known.
  
  
  RESULTS
  Ten PAH patients received an implantable hemodynamic monitor that continuously recorded and stored right ventricular systolic (RVSP) and mean pulmonary arterial (MPAP) pressures. Before starting a new PAH treatment (baseline) and after 12 weeks on treatment, a 6-minute walk test (6MWT) and a maximal walk test (MAXWT) were performed. Exercise pressure range was measured as the difference between rest before exercise and maximal pressure during 6MWT or MAXWT. Ambulatory range (AMB) was measured as the difference between the lowest (4th percentile) and highest (96th percentile) values recorded over 24 hours. One week of AMBs were averaged for each patient before each exercise test. Mean age was 54 ±18 years, 9 were female, and all were in World Health Organization functional class III. At baseline, RVSP and MPAP increased, respectively, 136 ± 49% and 164 ± 49% during AMB, 63 ± 26% and 79 ± 30% during MAXWT, and 59 ± 32% and 69 ± 33% during 6MWT. There was no difference in pressure change at 12 weeks.
  
  
  CONCLUSIONS
  Changes in RV and PA pressures during exercise tests were relatively small compared with the range seen during ambulatory conditions.
authors.affiliation: Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: barbro.kjellstrom@ki.se.
authors.forename: Barbro
authors.initials: B
authors.lastname: Kjellström
authors.affiliation: Division of Cardiovascular Diseases, College of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Frantz
authors.affiliation: Allegheny General Hospital, Pittsburgh, Pennsylvania.
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Benza
authors.affiliation: NT&D Research, Medtronic, Minneapolis, Minnesota.
authors.forename: Tom
authors.initials: T
authors.lastname: Bennett
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, University of Alabama, Birmingham, Alabama.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bourge
authors.affiliation: Division of Cardiovascular Diseases, College of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Michael D
authors.initials: MD
authors.lastname: McGoon
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016138:Walking / Q000502:physiology*
keywords: 6-minute walk test; Right ventricular pressure; ambulatory; maximal treadmill exercise test