Effects of PAH Specific Therapy on Pulmonary Hemodynamics and Six-Minute Walk Distance in Pulmonary Hypertension Secondary to Interstitial Lung Disease: A Meta-analysis

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 367A
Author(s):  
Bashar Mourad ◽  
Abubakr Bajwa ◽  
Adil Shujaat
Keyword(s):  
Pulmonary Hypertension ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Meta Analysis ◽  
Walk Distance ◽  
Specific Therapy ◽  
Pulmonary Hemodynamics ◽  
Minute Walk Distance ◽  
Minute Walk

scholarly journals Pulmonary Hemodynamics and Six-Minute Walk Test Outcomes in Patients with Interstitial Lung Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Osamu Nishiyama ◽  
Ryo Yamazaki ◽  
Hiroyuki Sano ◽  
Takashi Iwanaga ◽  
Yuji Higashimoto ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Walk Test ◽  
Walk Distance ◽  
Right Heart ◽  
Pulmonary Hemodynamics ◽  
Physiological Variables ◽  
Six Minute Walk Test ◽  
Right Heart Catheter ◽  
Minute Walk

Background. Six-minute walk test (6MWT) has 3 measurement outcomes, which are walk distance, desaturation, and symptom. The aim of this study was to examine whether routinely measured right-heart catheter (RHC) data correlate with 6MWT outcomes in patients with interstitial lung disease (ILD).Methods. Between June 2010 and December 2012, consecutive patients with ILD who underwent evaluation, including pulmonary function test, hemodynamic studies with right-heart catheter, and 6MWT as routine general practice, were recruited. Correlates of 3 outcomes of 6MWT were examined to reveal significant predictors.Results. Forty-six patients consisting of 20 with idiopathic pulmonary fibrosis, 14 with collagen vascular disease associated ILD, and 12 with other idiopathic interstitial pneumonia were recruited (mean % predicted FVC:76.7±17.1%). Several physiological variables, including mean pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR), were correlated with each 6MWT outcome. Stepwise multivariate regression analyses showed that % predicted FVC and % predicted DLco were independent predictors of walk distance (r2=0.35,p=0.0002). For SpO2at the end of 6MWT, % predicted DLco and PVR were selected as independent predictors (r2=0.46,p<0.0001). For dyspnea at the end of 6MWT, % predicted DLco was only one predictor (r2=0.18,p=0.005).Conclusion. Mean PAP had little impact on 6MWT outcomes in ILD patients who were nonselectively recruited, although PVR was one of predictors of desaturation.

scholarly journals Idiopathic pulmonary arterial hypertension and co-existing lung disease: is this a new phenotype?

2020 ◽  
Vol 10 (1) ◽  
pp. 204589402091485 ◽  
Author(s):  
Andrew J. Peacock ◽  
Yi Ling ◽  
Martin K. Johnson ◽  
David G. Kiely ◽  
Robin Condliffe ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Lung Disease ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Walk Distance ◽  
Pulmonary Arterial ◽  
Minute Walk Distance ◽  
Minute Walk ◽  
Group 1

Patients classified as idiopathic pulmonary arterial hypertension (defined as Group 1 on European Respiratory Society (ERS)/European Cardiac Society (ESC) criteria) may have evidence of minor co-existing lung disease on thoracic computed tomography. We hypothesised that these idiopathic pulmonary arterial hypertension patients ( IPAH lung disease) are a separate subgroup of idiopathic pulmonary arterial hypertension with different phenotype and outcome compared with idiopathic pulmonary arterial hypertension patients without co-existing lung disease ( IPAH no lung disease). Patients with ‘ IPAH lung disease’ have been eligible for all clinical trials of Group 1 patients because they have normal clinical examination and normal spirometry but we wondered whether they responded to treatment and had similar survival to patients with ‘ IPAH no lung disease’. We described the outcome of the cohort of patients with ‘ IPAH no lung disease’ in a previous paper. Here, we have compared incident ‘ IPAH lung disease’ patients with ‘ IPAH no lung disease’ patients diagnosed concurrently in all eight Pulmonary Hypertension centres in the UK and Ireland between 2001–2009. Compared with ‘ IPAH no lung disease’ ( n = 355), ‘ IPAH lung disease’ patients ( n = 137) were older, less obese, predominantly male, more likely to be current/ex-smokers and had lower six-minute walk distance, lower % predicted diffusion capacity for carbon monoxide, lower mean pulmonary arterial pressure and lower pulmonary vascular resistance index. After three months of pulmonary hypertension-targeted treatment, six-minute walk distance improved equally in ‘ IPAH lung disease’ and ‘ IPAH no lung disease’. However, survival of ‘ IPAH lung disease’ was lower than ‘ IPAH no lung disease’ (one year survival: 72% compared with 93%). This survival was significantly worse in ‘ IPAH lung disease’ even after adjusting for age, gender, smoking history, comorbidities and haemodynamics. ‘ IPAH lung disease’ patients had similar short-term improvement in six-minute walk distance with anti-pulmonary arterial hypertension therapy but worse survival compared with ‘ IPAH no lung disease’ patients. This suggests that ‘ IPAH lung disease’ are a separate phenotype and should not be lumped with ‘ IPAH no lung disease’ in clinical trials of Group 1 pulmonary arterial hypertension.

Review of the Latest Published Research

2013 ◽  
Vol 11 (4) ◽  
pp. 157-158
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Clinical Context ◽  
Walk Distance ◽  
Published Research ◽  
Minute Walk Distance ◽  
Minute Walk

Summaries and commentaries from the section editors and invited reviewers present a clinical context for practitioners' application of the latest published research relevant to the care of patients with pulmonary hypertension. In this issue, Kelly Chin discusses the role of computed tomography and 6-minute walk distance in the diagnosis of pulmonary hypertension patients.

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