Cardiopulmonary exercise test predicts right heart catheterization

Background Right heart catheterization (RHC) is usually required to confirm the diagnosis of pulmonary artery hypertension (PAH). As an invasive test, RHC may be associated with possible complications; so, non-invasive parameters able to predict PAH at RHC would be extremely useful. Aim To ascertain possible correlations between cardiopulmonary exercise testing (CPET) and hemodynamic parameters at RHC indicative of PH. Methods Thirty-six consecutive outpatients with suspect of PAH underwent CPET and RHC; the intercept of ventilation (VEint) on the VE vs. carbon dioxide production (VE/VCO2) and VE/VCO2 slope at CPET and Diastolic Pressure Gradient (DPG), Trans-pulmonary Pressure Gradient (TPG), mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) at RHC were assessed and compared. Results VE/VCO2 slope were directly related to DPG (r 0.41, p 0.019), TPG (r 0.45, p 0.01), mean pulmonary arterial pressure (mPAP, r 0.36, p 0.031), PVR (r 0.41, p 0.029), VEint and VE/VCO2 slope inversely related to DPG (r -0.63, p<0.001), TPG (r: -0.67, p<0.001), mPAP (r -0.68, p<0.001), and PVR (r -0.5, p<0.001). Conclusion In patients with suspected PAH, VEint during exercise and the VE/VCO2 slope might provide useful information to predict results of RHC. Their correlations with PVR and with DPG may be helpful in discriminating patients with isolated post-capillary PH from those with combined post-capillary and pre-capillary. This article is protected by copyright. All rights reserved.