The effect of pulmonary hypertension on aerobic exercise capacity in lung transplant candidates with advanced emphysema.
OBJECTIVE
Mild pulmonary hypertension (PH) in patients with advanced COPD is common, but its effects on exercise capacity are controversial. The objective of our study was to investigate the effects of mild PH (35 > mPAP ≥ 25 mmHg) on exercise capacity in patients with advanced emphysema, candidates for lung transplantation.


METHODS
We retrospectively reviewed and compare the data from right heart catheterization and cardiopulmonary exercise test, performed in patients with advanced emphysema, candidate for lung transplantation.


RESULTS
Twenty patients with emphysema and no PH and 24 patients with emphysema associated with mild PH included in the study. Both patient groups had severe airways obstruction with markedly reduced FEV1 (24.9% P ± 8.9 and 25.9% P ± 11.7, respectively), and severely reduced DLCO (35.2% P ± 17.3 and 39.2% P ± 15.9). Both patients group demonstrated mark reduction in maximum workload and peak VO2 together with increased ventilatory equivalent for CO2 and extremely low breathing reserve. There was no correlation between mPAP and any of the exercise measurement.


CONCLUSIONS
Our study suggests that exercise capacity in patients with advanced emphysema is limited by the ventilatory impairment and the presence of mild PH has no farther impact on exercise capability.
Pulmonary Division, Lady Davis Carmel Medical Center, Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.
Yochai
Y
Adir
Jacob E
JE
Ollech
Baruch
B
Vainshelboim
Yael
Y
Shostak
Arie
A
Laor
Mordechai R
MR
Kramer
D000368:Aged; D002248:Carbon Monoxide; D006328:Cardiac Catheterization; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005541:Forced Expiratory Volume; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology*; D016040:Lung Transplantation; D008875:Middle Aged; D010101:Oxygen Consumption; D011653:Pulmonary Diffusing Capacity; D011656:Pulmonary Emphysema / Q000150:complications / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure; D012189:Retrospective Studies
D002248:Carbon Monoxide