Cardiopulmonary Exercise Testing and Six-Minute Walk Correlations in Pulmonary Arterial Hypertension

Oudiz, Ronald J.; Barst, Robyn J.; Hansen, James E.; Sun, Xing‐Guo; Garofano, Robert P.; Wu, Xiaojie; Wasserman, Karlman

doi:10.1016/j.amjcard.2005.07.129

Cited by 135 publications

(110 citation statements)

References 18 publications

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“…Although lack of standardisation and insufficient expertise in performing cardiopulmonary exercise testing were identified as the main reasons explaining this discrepancy [81], the 6-MWT remains until now the only Food and Drug Administration-and European Agency for the Evaluation of Medicinal Productsaccepted exercise end-point for studies evaluating treatment effects in PAH. Despite detailed recommendations [84,85], a generally accepted standardisation of cardiopulmonary exercise testing with respect to data acquisition and analysis in PAH is lacking.…”

Section: Exercise Capacitymentioning

confidence: 99%

“…In PAH, O 2 uptake at the anaerobic threshold and peak exercise are reduced in relation to disease severity, as are peak work rate, peak heart rate, O 2 pulse and ventilatory efficiency [81]. Following multivariate analysis of clinical, haemodynamic and exercise parameters peak O 2 uptake (,10.4 mL O 2 ?kg -1 ?min -1 ) and peak systolic arterial pressure during exercise (,120 mmHg) independently predicted a worse prognosis in IPAH patients [75].…”

Section: Exercise Capacitymentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for the diagnosis and treatment of pulmonary hypertension

Galiè¹,

Hoeper²,

Humbert³

et al. 2012

Revista Portuguesa de Cardiologia (English Edition)

419

738

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Section: Exercise Capacitymentioning

confidence: 99%

Section: Exercise Capacitymentioning

confidence: 99%

Guidelines for the diagnosis and treatment of pulmonary hypertension

Galiè¹,

Hoeper²,

Humbert³

et al. 2012

Revista Portuguesa de Cardiologia (English Edition)

419

738

View full text Add to dashboard Cite

“…2 In addition, the 6MWT is a significant predictor of survival in patients with pulmonary hypertension [7][8][9][10][11] and is used in clinical trials for IPAH medications. 12 In addition to other health limiting and debilitating conditions, patients with lung or heart disease may show a reduced 6-minute walk distance (6MWD).…”

Section: Doi: 101097/hcr0000000000000174mentioning

confidence: 99%

“…Peak V o 2 , measured by a CPET, has been widely used to assess functional capacity and predict survival in patients with advanced symptomatic heart failure and respiratory dysfunction. 1,2 However, CPET requires the use of expensive equipment and trained medical team supervision to conduct and evaluate each test.…”

mentioning

confidence: 99%

Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension

Zapico

Fuentes

Rojo-Tirado

et al. 2016

Journal of Cardiopulmonary Rehabilitation and Prevention

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exercise testing oxygen uptake pulmonary hypertension ■ PURPOSE: To determine whether the 6-minute walk test (6MWT) is a predictor of peak oxygen uptake (Vo 2 ) in patients with idiopathic pulmonary arterial hypertension (IPAH).■ METHODS: A total of 157 patients treated for IPAH completed a 6MWT in accordance with American Thoracic Society standards. Heart rate, pulse oximetry, and Borg rating of perceived exertion were determined at baseline and posttest. A cardiopulmonary exercise test (CPET) was performed on a cycle ergometer using a ramp protocol. Participants were stratified post hoc by age into 3 groups: children (n = 26), adolescents (n = 49), and adults (n = 82). Multiple linear regression analysis was performed to predict peak Vo 2 from the 6MWT.■ RESULTS: The regression equation generated for the children was the only model to strongly predict peak Vo 2 (r = 0.87; P < .001). Similar models for adolescent (r = 0.59; P < .001) and adult groups (r = 0.68; P < .001) did not achieve the same level of correlation.■ CONCLUSION: Six-Minute Walk Test was able to accurately predict peak Vo 2 in children (6-12 years) with IPAH; however, the model was weaker for predicting peak Vo 2 in older populations. These findings suggest that 6MWT may be as valid a test for predicting peak Vo 2 in children with IPAH as CPET measured peak Vo 2 . In older IPAH populations, CPET is the only reliable method for the evaluation of peak Vo 2 . The cardiopulmonary response to exercise is an important clinical assessment tool, as it provides an integrated assessment of the respiratory, cardiac, and metabolic systems. The current gold standard method for assessing aerobic exercise response in humans is the maximum incremental cardiopulmonary exercise test (CPET). Peak V o 2 , measured by a CPET, has been widely used to assess functional capacity and predict survival in patients with advanced symptomatic heart failure and respiratory dysfunction. 1,2 However, CPET requires the use of expensive equipment and trained medical team supervision to conduct and evaluate each test. Submaximal tests, like the 6-minute walk test (6MWT), provide useful information on daily physical performance that are safe, simple, standardized, and inexpensive. The 6MWT offers a better estimation of daily living activities than other walk tests 3 and the American Thoracic Society has endorsed and published guidelines for performing the 6MWT in clinical settings. 4

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“…Untreated exercise ischemia can lead to inadequate supply of blood flow, or lack of oxygenation of the myocardium which in turn may lead to infarction and irreversible localize death of the heart tissue, as well as other heart conditions. Peak Oxygen Uptake (pVO₂), measured via CPET, has been widely used to assess functional capacity and predict survival in diseased populations such those with advanced symptomatic heart failure (Cahalin, Mathier, Semigran, Dec, & DiSalvo, 1996;Oudiz et al, 2006). Pulmonary vascular resistance was found to increase as pVO₂ (measured by CPET) and Cardiac Output, or volume of blood pumped by the heart per unit time (CO), decreased in patients with heart failure (Butler, Chomsky, & Wilson, 1999).…”

Section: 141clinical Exercise Testing In Heart Diseasementioning

confidence: 99%

Application of exercise testing in the diagnosis, prognosis, and treatment of patients with Pulmonary Hypertension

Sánchez¹

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AcknowledgementTo my wife Kirsten for taking onto this project with me and for her unconditional support. To my children Lola, Luna, and Beck for being my inspiration throughout these years and the years to come and for teaching me the meaning of unconditional love.To my parents for their constant support helping my dreams come true. For instilling in me the need to always keep on learning, advancing, and improving, questioning everything and never taking anything at face value.To my brother and sister for constantly pushing me to a higher level and believing in my abilities.To my aunts, grandparents, and family for teaching me to love above everything.To Augusto for his confidence in me, for believing in me, and pushing me to higher levels.To my coaches and especially Javier Castañón for sparking in me the love for exercise physiology.To all my swimming friends for suffering with me and teaching me that all effort pays off.To all my professors and to Javier Calderón for introducing me to physiology and for supporting this endeavor.To Bob for being a role model and a mentor, for teaching me about clinical exercise physiology and about life.To Siwat for supporting and encouraging this endeavor. XTo the late Dr.Mellins for offering me his selfless help and guidance.To the proofreaders, reviewers, and consultants: Debbie, Ryan, Oscar, Carles, Miguel. XI AgradecimientosA mi mujer Kirsten por embarcarse en este proyecto conmigo y por su apoyo incondicional. A mis hijas Lola, Luna y a mi hijo Beck por ser mi inspiración durante estos años y en los años venideros, así como por enseñarme el significado del amor incondicional.A mis padres por su apoyo constante, por ayudarme a cumplir mis sueños, por inculcar en mi la necesidad de continuar aprendiendo siempre, de avanzar, mejorar y preguntarme el porqué de todo y no aceptar las cosas porque si.A mi hermano y hermana por empujarme continuamente a ser mejor y por su confianza en mis habilidades.A mis tías, abuelos, abuelas y familia por enseñarme a querer por encima de todo.A Augusto por estar siempre ahí, confiar y creer en mí, apoyarme y empujarme a alcanzar cotas superiores.A mis entrenadores a lo largo de los años y en especial a Javier Castañón por despertar en mí el amor por la fisiología del ejercicio.A todos mis compañeros de natación por sufrir conmigo y enseñarme que el esfuerzo tiene su recompensa.A todos mis profesores y a Javier Calderón por introducirme a la fisiología y apoyar esta aventura.A Bob por ser un mentor, un modelo a seguir y por sus lecciones sobre la fisiología del ejercicio clínica y sobre la vida. XIIA Siwat por apoyar y fomentar esta aventura.Al Doctor Mellins, que ya no está con nosotros, por ofrecer su generosa ayuda, consejos y dirección.

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Cardiopulmonary Exercise Testing and Six-Minute Walk Correlations in Pulmonary Arterial Hypertension

Cited by 135 publications

References 18 publications

Guidelines for the diagnosis and treatment of pulmonary hypertension

Guidelines for the diagnosis and treatment of pulmonary hypertension

Predicting Peak Oxygen Uptake From the 6-Minute Walk Test in Patients With Pulmonary Hypertension

Application of exercise testing in the diagnosis, prognosis, and treatment of patients with Pulmonary Hypertension

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