In SSc, Cardiopulmonary Exercise Test May Help Detect PAH, Study Says - Scleroderma News

In SSc, Cardiopulmonary Exercise Test May Help Detect PAH, Study Says - Scleroderma News

In SSc, Cardiopulmonary Exercise Test May Help Detect PAH, Study Says - Scleroderma News

Posted: 27 Nov 2019 09:00 AM PST

Cardiopulmonary exercise testing (CPET), along with an algorithm that considers both lung and heart functions, can help lower the unnecessary use of right heart catheterization to determine if a scleroderma patient has pulmonary arterial hypertension, a study reports.

The study, "Cardiopulmonary exercise testing in a combined screening approach to individuate pulmonary arterial hypertension in systemic sclerosis," appeared in the journal Rheumatology.

Pulmonary arterial hypertension (PAH) — a frequent and severe complication of scleroderma (SSc) — is characterized by thickening of connective tissue which narrows small arteries in the lung. This narrowing, in turn, increases pressure within pulmonary blood vessels.

Early detection and treatment of SSc-PAH has been associated with better prognosis but specific markers and symptoms have not been extensively investigated.

An algorithm called DETECT (a set of criteria related to heart and lung function) has led to a lower rate of missed diagnoses than other approaches. However, its low ability to identify SSc patients with little risk of PAH has led to frequent use of an invasive procedure called right heart catheterization.

CPET has been useful in the diagnosis of cardiopulmonary diseases, such as PAH, with recent evidence suggesting similar utility in scleroderma.

In the study, researchers in Italy investigated whether CPET could improve the performance of the DETECT-based screening strategy.

Over a 30-month period, the researchers screened 314 scleroderma patients. Of these, 54 individuals (two men and 52 women; mean age of 63.4 years) were deemed at risk for PAH according to the DETECT algorithm. As a result, they were referred to CPET before undergoing right heart catheterization.

CPET was conducted using a stationary cycle ergometer where patients worked up to the maximum exercise capacity that they can maintain for eight to 12 minutes, followed by three minutes of recovery.

Seventeen patients (31.5%) were diagnosed with PAH, according to the European Society of Cardiology/European Respiratory Society guidelines. Also, 23 patients (42.6%) had pre-capillary pulmonary hypertension, which is caused by blood pressure elevation in the pulmonary arterial system alone.

Importantly, an increased ratio of minute ventilation to carbon dioxide production — the VE/VCO2 slope — in CPET was the best predictor of both pre-capillary and PAH diagnosis at right heart catheterization.

"In association with the DETECT algorithm, CPET may be considered as a useful tool in the workup of SSc-related pulmonary hypertension," the researchers wrote.

"The sequential determination of the VE/VCO2 slope in DETECT-positive subjects may reduce the number of unnecessary invasive procedures without any loss in the capability to capture PAH," they added.

  • Author Details
With over three years of experience in the medical communications business, Catarina holds a BSc. in Biomedical Sciences and a MSc. in Neurosciences. Apart from writing, she has been involved in patient-oriented translational and clinical research.
Total Posts: 27
José is a science news writer with a PhD in Neuroscience from Universidade of Porto, in Portugal. He has also studied Biochemistry at Universidade do Porto and was a postdoctoral associate at Weill Cornell Medicine, in New York, and at The University of Western Ontario in London, Ontario, Canada. His work has ranged from the association of central cardiovascular and pain control to the neurobiological basis of hypertension, and the molecular pathways driving Alzheimer's disease.
×
With over three years of experience in the medical communications business, Catarina holds a BSc. in Biomedical Sciences and a MSc. in Neurosciences. Apart from writing, she has been involved in patient-oriented translational and clinical research.
Latest Posts

Comments

Post a Comment

Popular posts from this blog

Epoprostenol Via High-Flow Nasal Cannula Improves Severe Hypoxemia in PH - Pulmonology Advisor

Image
Epoprostenol Via High-Flow Nasal Cannula Improves Severe Hypoxemia in PH - Pulmonology Advisor Epoprostenol Via High-Flow Nasal Cannula Improves Severe Hypoxemia in PH - Pulmonology Advisor Posted: 11 Jul 2019 12:00 AM PDT For patients with severe hypoxemia with pulmonary hypertension or right heart dysfunction, inhaled epoprostenol through high-flow nasal cannula increases oxygenation, according to a study published in Pharmaceutics . The researchers of this retrospective study assessed the effect of inhaled epoprostenol using a high-flow nasal cannula on oxygenation and future mechanical ventilation in patients with hypoxemia comorbid with pulmonary hypertension or right heart dysfunction in an intensive care unit setting. A chart review was completed on adult patients who were admitted into the respiratory care department of the Rush University Medical Center for severe hypoxemia between July 2015 and April 2018 and treated with inha...
Read more

Dyspnea (Shortness of Breath): Causes, Symptoms & Treatment - my.clevelandclinic.org

Image
Overview Shortness of breath (dyspnea) is most commonly caused by heart or lung conditions. Other causes include anemia, anxiety, lack of exercise or living with obesity. What is dyspnea (shortness of breath)? Dyspnea (pronounced "DISP-nee-uh") is the word healthcare providers use for feeling short of breath. You might describe it as not being able to get enough air ("air hunger"), chest tightness or working harder to breathe. Shortness of breath is often a symptom of heart and lung problems. But it can also be a sign of other conditions like asthma, allergies or anxiety. Intense exercise or having a cold can also make you feel breathless. What are paroxysmal nocturnal dyspnea (PND) and sighing dyspnea? Paroxysmal nocturnal dyspnea (PND) is a feeling like you can't breathe an hour or two after falling asleep. Sighing dyspnea is when you sigh a lot after taking deep breaths in to try to relieve the feeling of dyspnea. What is the differ...
Read more

What to Expect During Pulmonary Embolism Recovery - Healthline

Image
What to Expect During Pulmonary Embolism Recovery - Healthline What to Expect During Pulmonary Embolism Recovery - Healthline Pulmonary Arterial Hypertension: Updates in Epidemiology and Evaluation of Patients - AJMC.com Managed Markets Network Right-Sided Heart Failure: Symptoms, Causes, and Treatments - Healthline Right sided heart failure: Symptoms, outlook, treatment - Medical News Today What to Expect During Pulmonary Embolism Recovery - Healthline Posted: 19 May 2021 12:00 AM PDT A pulmonary embolism (PE) is when a blood clot becomes stuck in the blood vessels of your lung. These clots typically begin in the leg and then break free and travel to the lung. The American Lung Association estimates that about 1 in 1,000 people in the United States experience a PE each year. A PE can be a serious or life threatening condition, which means receiving prompt medical treatment is vital. Treatment of a PE focus...
Read more