title: Kinetics of Cardiac Output at the Onset of Exercise in Precapillary Pulmonary Hypertension.
abstract: Purpose.Cardiac output (CO) is a cornerstone parameter in precapillary pulmonary hypertension (PH). The Modelflow (MF) method offers a reliable noninvasive determination of its beat-by-beat changes. So MF allows exploration of CO adjustment with the best temporal resolution.Methods.Fifteen subjects (5 PH patients, 10 healthy controls) performed a submaximal supine exercise on a cycle ergometer after 5 min of rest. CO was continuously determined by MF (COMF). Kinetics of heart rate (HR), stroke volume (SV), and CO were determined with 3 monoexponential models.Results.In PH patients, we observed a sudden and transitory drop of SV upon exercise onset. This implied a transitory drop of CO whose adjustment to a new steady state depended on HR increase. The kinetics of HR and CO for PH patients was slower than that of controls for all models and for SV in model 1. SV kinetics was faster for PH patients in models 2 and 3.Conclusion.This is the first description of beat-by-beat cardiovascular adjustments upon exercise onset in PH. The kinetics of HR and CO appeared slower than those of healthy controls and there was a transitory drop of CO upon exercise onset in PH due to a sudden drop of SV.
authors.affiliation: Service de Pneumologie, Programme Hypertension Pulmonaire, Hôpitaux Universitaires de Genève, Genève, Switzerland; Faculté de Médecine, Université de Genève, Genève, Switzerland.
authors.forename: Frédéric
authors.identifier: 0000-0002-4276-635X
authors.initials: F
authors.lastname: Lador
authors.affiliation: Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Faculté de Médecine, Université de Genève, Genève, Switzerland.
authors.forename: Aurélien
authors.identifier: 0000-0003-2747-5068
authors.initials: A
authors.lastname: Bringard
authors.affiliation: Faculté de Médecine, Université de Genève, Genève, Switzerland.
authors.forename: Samir
authors.initials: S
authors.lastname: Bengueddache
authors.affiliation: Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Faculté de Médecine, Université de Genève, Genève, Switzerland; Département de Médecine Moléculaire et Translationnelle, Université de Brescia, Brescia, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Ferretti
authors.affiliation: Département d'Anesthésiologie, Pharmacologie et Soins Intensifs, Faculté de Médecine, Université de Genève, Genève, Switzerland.
authors.forename: Karim
authors.identifier: 0000-0002-7921-7207
authors.initials: K
authors.lastname: Bendjelid
authors.affiliation: Service de Pneumologie, Programme Hypertension Pulmonaire, Hôpitaux Universitaires de Genève, Genève, Switzerland; Faculté de Médecine, Université de Genève, Genève, Switzerland.
authors.forename: Paola M
authors.initials: PM
authors.lastname: Soccal
authors.affiliation: Faculté de Médecine, Université de Genève, Genève, Switzerland; Service de Cardiologie, Hôpitaux Universitaires de Genève, Genève, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Noble
authors.affiliation: Faculté de Médecine, Université de Genève, Genève, Switzerland; Unité de Cardiopédiatrie, Programme Hypertension Pulmonaire, Hôpitaux Universitaires de Genève, Genève, Switzerland.
authors.forename: Maurice
authors.initials: M
authors.lastname: Beghetti
authors.affiliation: Université Paris-Sud, Le Kremlin-Bicêtre, France; INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Chemla
authors.affiliation: Université Paris-Sud, Le Kremlin-Bicêtre, France; INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hervé
authors.affiliation: AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Sitbon
mesh_terms: D000328:Adult; D002302:Cardiac Output; D015444:Exercise; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume