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Incremental step test in patients with pulmonary hypertension
E B Vieira1, J S Ota-Arakaki1, S Dal Corso2
1Pulmonary Function and Exercise Physiology Unit. Division of Respiratory Diseases, Department of Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.
Respiratory Physiology & Neurobiology
|September 27, 2019
Summary
An incremental step test (IST) is a viable alternative to cardiopulmonary exercise testing (CPET) for assessing patients with pre-capillary pulmonary hypertension (PH). IST elicits higher peak responses and aligns with established severity markers.
Area of Science:
- Cardiopulmonary physiology
- Exercise testing
- Pulmonary hypertension
Background:
- Cardiopulmonary exercise testing (CPET) is standard for assessing cardiorespiratory function during exertion.
- Incremental step testing (IST) offers a potential alternative for maximal exercise response evaluation.
Purpose of the Study:
- To compare the efficacy of IST versus CPET in patients with pre-capillary pulmonary hypertension (PH).
- To evaluate IST as a tool for assessing cardiorespiratory responses and disease severity.
Main Methods:
- Twenty patients with pre-capillary PH underwent symptom-limited CPET and IST on a cycle ergometer.
- Metabolic, cardiovascular, ventilatory, and gas exchange variables were recorded during both tests.
Main Results:
- IST resulted in greater desaturation and higher peak oxygen consumption (V̇O2PEAK) compared to CPET.
- Key parameters like V̇O2GET, HRPEAK, ΔV̇E/ΔV̇CO2, and ΔHR/ΔV̇O2 showed similarity between IST and CPET.
- Work performed during IST predicted peak V̇O2 independently of age and gender.
Conclusions:
- IST effectively elicits higher peak cardiopulmonary responses in pre-capillary PH patients.
- IST demonstrates good agreement with established markers of disease severity, supporting its clinical utility.
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