Page 16 - Assessing right ventricular function and the pulmonary circulation in pulmonary hypertension Onno Anthonius Spruijt

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A study by Gruenig et al [39] used the rise in systolic pulmonary artery pressure (sPAP) during exercise, assessed with echocardiography, as a measure of the contractile reserve of the RV. They showed in PAH and CTEPH patients that the increase of sPAP during exercise was an independent predictor of survival with a better survival in the patients with a bigger contractile reserve [39]. Likewise, changes in PVR and PCWP from rest to exercise are poorly characterized. A recent meta- analysis showed that changes in PVR and PAWP during exercise dependent on age [40].
Despite the suggestion that evaluation of the hemodynamic response to exercise aids the early detection of pathological cardiopulmonary changes and the distinction between exercise-induced PH and left-sided diastolic dysfunction [34, 38], more and more widely disseminated experience with invasive CPET is necessary to determine its value.