Key result
Patients with chronic lung disease and high pulmonary vascular resistance had significantly greater maximum desaturation during the 2-chair test compared to those with low resistance (-8.76% vs -3.61%), with a >4.5% cut-off yielding 72.22% sensitivity and 79.40% specificity.
Why the study?
Maximum desaturation in the 2-chair test, claimed to identify sildenafil responsiveness in COPD-pulmonary hypertension, should represent high pulmonary vascular resistance.
Does the maximum desaturation in the 2-chair test accurately identify high pulmonary vascular resistance in patients with chronic lung disease and pulmonary hypertension?
Cross-Sectional (n=57)
No
Does the maximum desaturation in the 2-chair test accurately identify high pulmonary vascular resistance in patients with chronic lung disease and pulmonary hypertension?
The maximum desaturation during the 2-chair test is a useful non-invasive indicator of high pulmonary vascular resistance in patients with chronic lung disease and pulmonary hypertension.
Answers are grounded in this paper and cite their sources.
May flag high pulmonary vascular resistance via simple desaturation; hypothesis-generating and requires validation before clinical use.
Introduction: The desat max of 2-chair test, claimed to have identified the sildenafil responsiveness in COPD-PH (pulmonary hypertension), should represent high PVR (pulmonary vascular resistance). Methods: Hemodynamically diagnosed PH in CLD (chronic lung disease)-patients were analyzed statistically and divided into two groups on high or low PVR (> 2 and ≤ 2 Wood units) to judge the power of the desat-max of 2-chair test differentiating them. Co-relationship of desat-max was sought with different spirometric, Doppler-echocardiographic, and RHC (right heart catheterization) derived parameters as TPG (trans-pulmonary gradient), PVR, mPAP (mean pulmonary pressure) and PCWP (pulmonary capillary wedge pressure). Further, the specificity and sensitivity of variable desat-max values were calculated and high PVR and a VIP plot was drawn with all available variables to see their impact on PVR compared to desat-max. Results: We included 57 patients of CLD-PH consisting of COPD (n=26), chronic asthma (n=9), ILD (n=7), and miscellaneous diseases (n=15). When divided on high or low PVR, the two groups (n=39 and 18) stood similar in demographic, spirometric, and Doppler-echocardiography measurements. However, they differed in desat-max (− 8.76± 4.90 and − 3.61± 1.94; P < 0.0001) and in RHC derived mean-PVR (4.25± 2.97 vs 1.20± 0.53; P < 0.0001), mean-TPG (12.86± 4.84 vs 5.11± 2.78; P < 0.0001), cardiac output (3.77± 1.07 and 4.29± 1.15; P =0.02). The calculated best cut-off desat-max (> 4.5%) could identify high PVR with 72.22% sensitivity and 79.40% specificity with adjusted odds ratio of 19.55. The desat-max correlated best with RHC-measured PVR (r=0.56) but not with PCWP (r=0.09). Conclusion: Desat-max of 2-chair test appears indicative of high PVR in CLD-PH. The revelation merits further research.
No takes yet. Share an insight, caveat, or question.
Bhattacharyya et al. (2025) conducted a cross-sectional in Chronic lung disease with pulmonary hypertension (n=57). High pulmonary vascular resistance (>2 Wood units) vs. Low pulmonary vascular resistance (≤2 Wood units) was evaluated on Maximum desaturation (desat-max) during the 2-chair test (p=<0.0001). Patients with chronic lung disease and high pulmonary vascular resistance had significantly greater maximum desaturation during the 2-chair test compared to those with low resistance (-8.76% vs -3.61%), with a >4.5% cut-off yielding 72.22% sensitivity and 79.40% specificity.
Synapse has enriched 10 related papers. Consider them for comparative context: