dead space ventilation in cardiaovascular disease cpet

Dead Space Ventilation in Cardiovascular Disease: A Comparative Study with CPET

Cardio-pulmonary Exercise Testing (CPET) is a diagnostic tool used to assess the functional capacity of patients with cardiovascular disease, particularly those suffering from Pulmonary Hypertension (PH). Recent studies have highlighted the importance of PetCO 2 values in understanding the exercise response and its relation to the etiology of PH. This article aims to investigate the patterns of dead space ventilation in IPAH and CTEPH patients during incremental CPET.

The study recruited 64 IPAH patients and 135 CTEPH patients from Shanghai Pulmonary Hospital between 2010 and 2020. All patients underwent right-heart catheterization (RHC) and performed CPET, which included measurements of end-tidal PCO2 (PetCO2) values during exercise testing. The results showed that PetCO2 values were significantly higher in IPAH patients compared to CTEPH patients during all phases of exercise (p < 0.001).

Interestingly, CTEPH patients demonstrated a significant difference in PetCO2 values only at peak exercise. Moreover, the study found that PetCO2 values decreased proportionately with increasing World Health Organization functional class (WHO-Fc) in both IPAH and CTEPH patients. This suggests that dead space ventilation increases as the severity of PH worsens.

Another notable finding was that PetCO2 did not rise during exercise testing, but instead fell from rest to anaerobic threshold (AT), followed by a further decrease until peak in both IPAH and CTEPH patients. This pattern is distinct from normal subjects, who typically experience an increase in PetCO2 values during exercise.

In conclusion, this study highlights the importance of dead space ventilation in understanding the exercise response in patients with cardiovascular disease, particularly those suffering from PH. The findings suggest that IPAH patients exhibit a unique pattern of PetCO2 changes during CPET compared to CTEPH patients. Further research is needed to fully understand the implications of these results and their potential applications in clinical practice.

Dead space ventilation in cardiaovascular disease cpet