This review highlights the contribution of right ventricular dysfunction and systemic/peripheral abnormalities to exercise intolerance in pulmonary arterial hypertension, emphasizing the utility of cardiopulmonary exercise testing.
May aid comprehensive PAH exercise evaluation; leaves open prospective validation of CPET-guided strategies.
Pulmonary arterial hypertension (PAH) is associated with symptoms of dyspnea and fatigue, which contribute to exercise limitation. The origins and significance of dyspnea and fatigue in PAH are not completely understood. This has created uncertainly among healthcare professionals regarding acceptable levels of these symptoms, on exertion, for patients with PAH. Dysfunction of the right ventricle (RV) contributes to functional limitation and mortality in PAH; however, the role of the RV in eliciting dyspnea and fatigue has not been thoroughly examined. This paper explores the contribution of the RV and systemic and peripheral abnormalities to exercise limitation and symptoms in PAH. Further, it explores the relationship between exercise abnormalities and symptoms, the utility of the cardiopulmonary exercise test in identifying RV dysfunction, and offers suggestions for further research.
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Fowler et al. (2012) studied this question.
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