Universität zu Köln

Dumitrescu, Daniel, Oudiz, Ronald J., Karpouzas, George, Hovanesyan, Arsen, Jayasinghe, Amali, Hansen, James E., Rosenkranz, Stephan and Wasserman, Karlman (2010). Developing Pulmonary Vasculopathy in Systemic Sclerosis, Detected with Non-Invasive Cardiopulmonary Exercise Testing. PLoS One, 5 (12). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Background: Patients with systemic sclerosis (SSc) may develop exercise intolerance due to musculoskeletal involvement, restrictive lung disease, left ventricular dysfunction, or pulmonary vasculopathy (PV). The latter is particularly important since it may lead to lethal pulmonary arterial hypertension (PAH). We hypothesized that abnormalities during cardiopulmonary exercise testing (CPET) in patients with SSc can identify PV leading to overt PAH. Methods: Thirty SSc patients from the Harbor-UCLA Rheumatology clinic, not clinically suspected of having significant pulmonary vascular disease, were referred for this prospective study. Resting pulmonary function and exercise gas exchange were assessed, including peakVO(2), anaerobic threshold (AT), heart rate-VO2 relationship (O-2-pulse), exercise breathing reserve and parameters of ventilation-perfusion mismatching, as evidenced by elevated ventilatory equivalent for CO2 (VE/VCO2) and reduced end-tidal pCO(2) (PETCO2) at the AT. Results: Gas exchange patterns were abnormal in 16 pts with specific cardiopulmonary disease physiology: Eleven patients had findings consistent with PV, while five had findings consistent with left-ventricular dysfunction (LVD). Although both groups had low peak VO2 and AT, a higher VE/VCO2 at AT and decreasing PETCO2 during early exercise distinguished PV from LVD. Conclusions: Previously undiagnosed exercise impairments due to LVD or PV were common in our SSc patients. Cardiopulmonary exercise testing may help to differentiate and detect these disorders early in patients with SSc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dumitrescu, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Oudiz, Ronald J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Karpouzas, George UNSPECIFIED UNSPECIFIED UNSPECIFIED Hovanesyan, Arsen UNSPECIFIED UNSPECIFIED UNSPECIFIED Jayasinghe, Amali UNSPECIFIED UNSPECIFIED UNSPECIFIED Hansen, James E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Wasserman, Karlman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-490728
DOI:	10.1371/journal.pone.0014293
Journal or Publication Title:	PLoS One
Volume:	5
Number:	12
Date:	2010
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VENTILATORY EFFICIENCY; ARTERIAL-HYPERTENSION; VENOOCCLUSIVE DISEASE; ANAEROBIC THRESHOLD; HEART-FAILURE; GAS-EXCHANGE; PATHOPHYSIOLOGY; LIMITATION; LUNG Multiple languages Multidisciplinary Sciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/49072