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Related Experiment Video

Updated: Jan 8, 2026

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise
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Invasive Cardiopulmonary Exercise Testing Identifies Distinctive Hemodynamic Phenotypes in Patients with Interstitial

Bathmapriya Balakrishnan1, Abhilash Marakini2, Luke Detloff3

  • 1Division of Pulmonary Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio, USA, p.bala1286@gmail.com.

Respiration; International Review of Thoracic Diseases
|December 15, 2025
PubMed
Summary
This summary is machine-generated.

Interstitial lung disease (ILD) patients with exercise intolerance exhibit diverse hemodynamic profiles. Invasive cardiopulmonary exercise testing (iCPET) reveals worsening exercise performance correlating with pulmonary hypertension severity.

Keywords:
Cardiopulmonary exercise testExercise intoleranceInterstitial lung diseasePulmonary hypertensionRight heart catheterization

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Area of Science:

  • Cardiology
  • Pulmonology
  • Exercise Physiology

Background:

  • Interstitial lung disease (ILD) is often associated with pulmonary vascular abnormalities, contributing to physiological impairments.
  • Exercise intolerance is a common symptom in ILD patients, but its underlying hemodynamic causes are not fully understood.

Purpose of the Study:

  • To investigate the heterogeneous hemodynamic profiles of ILD patients experiencing exercise intolerance.
  • To assess these profiles using invasive cardiopulmonary exercise testing (iCPET) and identify correlations with disease severity and exercise capacity.

Main Methods:

  • Prospective study involving 43 ILD patients from January 2018 to December 2023.
  • Utilized iCPET to evaluate hemodynamic parameters at rest and during exercise.
  • Analyzed various pulmonary hypertension (PH) classifications and their association with exercise intolerance.

Main Results:

  • Diverse PH phenotypes were observed, including no PH, no PH with elevated pulmonary vascular resistance (PVR), pre-capillary PH, and post-capillary PH.
  • Patients with higher PVR and pre-capillary PH showed significantly lower lung function and oxygenation.
  • Hemodynamic parameters like mPAP/CO and PAWP/CO slopes worsened progressively from no PH to pre-capillary PH groups.

Conclusions:

  • ILD patients with exercise intolerance present with multiple distinct hemodynamic phenotypes.
  • Hemodynamic status, ranging from no PH to pre-capillary PH, significantly impacts exercise performance in ILD.