An observational analysis of exercise capacity in CTEPH patients after pulmonary endarterectomy

D. Ruigrok, P. Symersky, E. Nossent, A. Boonstra, A. Noordegraaf, L. Meijboom, H. Bogaard
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Abstract

Introduction: Although pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension (CTEPH) is a highly effective treatment with significant improvements in hemodynamics and right ventricular function, persistent exercise limitation is frequent with many unknowns regarding its mechanisms. Aims: In an observational analysis we aimed to analyze the changes in exercise parameters post-PEA and identify persistent exercise pathology typical for CTEPH. Methods: We analyzed 68 CTEPH patients with cardiopulmonary exercise testing 6 months post-PEA. Results: 6 months post-PEA max load and peakVO2 significantly improved compared to baseline; circulatory and gas exchange parameters (O2 pulse, PETCO2, VE/VCO2, SpO2) improved, while ventilatory parameters remained unchanged. 42/68 (62%) had persistent exercise limitation 6 months post-PEA (peakVO2 Conclusions: In 68 CTEPH patients exercise capacity significantly improved after PEA; improvements were mainly in the circulatory and gas exchange domain. Persistent exercise limitation was frequent and mainly due to cardiocirculatory pathology. Signs typical of pulmonary vascular limitation during exercise were frequent after PEA in CTEPH.
肺内膜切除术后CTEPH患者运动能力的观察分析
虽然肺动脉内膜切除术(PEA)治疗慢性血栓栓塞性肺动脉高压(CTEPH)是一种非常有效的治疗方法,可以显著改善血液动力学和右心室功能,但持续运动限制是常见的,其机制尚不清楚。目的:在一项观察性分析中,我们旨在分析pea后运动参数的变化,并确定CTEPH典型的持续运动病理。方法:对68例CTEPH患者在pea术后6个月进行心肺运动试验进行分析。结果:与基线相比,pea后6个月最大负荷和峰值vo2显著改善;循环和气体交换参数(O2脉冲、PETCO2、VE/VCO2、SpO2)改善,而通气参数保持不变。42/68(62%)患者在PEA后6个月持续运动受限。改进主要在循环和气体交换领域。持续的运动限制是常见的,主要是由于心脏循环病理。典型的运动期间肺血管受限的征象在CTEPH的PEA后很常见。
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