Key result
Patients with reduced pulmonary vascular distensibility (<0.7% per mm Hg) had worse RV:PA coupling and lower exercise capacity compared to those with higher distensibility.
Why the study?
Does reduced pulmonary vascular distensibility correlate with worse RV:PA coupling and exercise capacity in patients with suspected pulmonary hypertension?
Does reduced pulmonary vascular distensibility correlate with worse RV:PA coupling and exercise capacity in patients with suspected pulmonary hypertension?
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A user-friendly, web-based calculator for pulmonary vascular distensibility can stratify patients with suspected pulmonary hypertension by severity of RV:PA uncoupling and exercise impairment.
imilar to Thomas Syndenham linking (systemic) arteries with an individual's health in 1600s, 1 pulmonary vascular health has been linked to exercise intolerance and clinical outcomes in recent years. These reports include rare diseases such as pulmonary arterial hypertension (PAH) and common diseases such as heart failure with preserved ejection fraction. Pulmonary vascular health can be quantified by hemodynamic afterload faced by the right ventricle (RV afterload), which comprises steady and pulsatile components. Although the steady load is captured by clinical metrics of pulmonary vascular resistance (PVR), the pulsatile load can be assessed with variable precision by different metrics: the simplified metric of pulmonary arterial compliance computed as stroke volume/pulmonary pulse pressure, 7 bioengineering metrics of pulmonary vascular impedance, 8,9 and pulmonary vascular distensibility with exercise
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Raza et al. (2023) conducted an editorial in Suspected pulmonary hypertension (n=40). Reduced pulmonary vascular distensibility (<0.7% per mm Hg) vs. Higher pulmonary vascular distensibility (≥0.7% per mm Hg) was evaluated on RV:PA coupling (TAPSE/PASP ratio). Patients with reduced pulmonary vascular distensibility (<0.7% per mm Hg) had worse RV:PA coupling and lower exercise capacity compared to those with higher distensibility.
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