PMID- 26134583
OWN - NLM
STAT- MEDLINE
DCOM- 20160621
LR  - 20180425
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Linking)
VI  - 149
IP  - 2
DP  - 2016 Feb
TI  - Loss of Vascular Distensibility During Exercise Is an Early Hemodynamic Marker of
      Pulmonary Vascular Disease.
PG  - 353-361
LID - S0012-3692(15)00118-X [pii]
LID - 10.1378/chest.15-0125 [doi]
AB  - BACKGROUND: Exercise can distend the normally compliant, thin-walled pulmonary
      vessels. Loss of distensibility has been suggested as an early marker of
      pulmonary vascular remodeling. We hypothesized that in mild pulmonary vascular
      disease (PVD), a reduction in vascular distensibility during exercise occurs
      prior to the development of overt resting pulmonary hypertension (PH). METHODS:
      Distensibility alpha during exercise (percentage change in vessel diameter per mm
      Hg increase in transmural pressure) was estimated in 90 subjects using a model of
      the pulmonary circulation and invasive hemodynamic data. Distensible properties
      in mild PVD without resting PH (PVD-noPH) (n = 33) were compared with control
      subjects (n = 26) and PVD with overt resting PH (PVD-PH) (n = 31). RESULTS:
      Resting mean pulmonary artery pressure (mPpa) levels were 14 +/- 4, 20 +/- 3, and
      34 +/- 10 mm Hg with corresponding exercise mPpa-cardiac output slopes of 1.5 +/-
      0.6, 3.5 +/- 0.9, and 5.7 +/- 3.2 mm Hg/L/min for control subjects and the
      PVD-noPH and PVD-PH groups, respectively. The distensible model produced high
      accuracy and precision with no mean bias and 95% limits of agreement of -4.5 to
      4.5 mm Hg between calculated and measured mPpa. Distensibility alpha was lowest
      in the PVD-PH group, intermediate in the PVD-noPH group, and highest in control
      subjects (0.25 +/- 0.14%/mm Hg vs 0.45 +/- 0.24%/mm Hg vs 1.40 +/- 0.45%/mm Hg, P
      < .0001). Distensibility alpha discriminated PVD-noPH from control subjects with 
      a sensitivity of 88% and a specificity of 100%. The discriminatory performance of
      alpha was similar for the subgroup of PVD-noPH, with a strictly normal resting
      mPpa </= 20 mm Hg. CONCLUSIONS: Loss of pulmonary vascular distensibility during 
      exercise occurs prior to resting PH in PVD. The usefulness of alpha as a novel
      vascular index for the early detection of PVD warrants further validation.
CI  - Copyright (c) 2016 American College of Chest Physicians. Published by Elsevier
      Inc. All rights reserved.
FAU - Lau, Edmund M T
AU  - Lau EMT
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Sydney Medical School, University of Sydney, Camperdown,
      NSW, Australia. Electronic address: edmund.lau@sydney.edu.au.
FAU - Chemla, Denis
AU  - Chemla D
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Godinas, Laurent
AU  - Godinas L
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France; CHU Mont-Godinne, Universite Catholique de Louvain, 
      Yvoir, Belgium.
FAU - Zhu, Kaixian
AU  - Zhu K
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Sitbon, Olivier
AU  - Sitbon O
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Savale, Laurent
AU  - Savale L
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Montani, David
AU  - Montani D
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Jais, Xavier
AU  - Jais X
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Celermajer, David S
AU  - Celermajer DS
AD  - Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.
FAU - Simonneau, Gerald
AU  - Simonneau G
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Humbert, Marc
AU  - Humbert M
AD  - Universite Paris-Sud, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Le Kremlin-Bicetre, France and Assistance
      Publique-Hopitaux de Paris, Service de Pneumologie, Centre de Reference de
      l'Hypertension Pulmonaire Severe, DHU Thorax Innovation, Hopital Bicetre, Le
      Kremlin-Bicetre, France; Institut National de la Sante et de la Recherche
      Medicale (INSERM) UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue,
      Le Plessis Robinson, France.
FAU - Herve, Philippe
AU  - Herve P
AD  - Departement de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire,
      Hopital Marie Lannelongue, Le Plessis Robinson, France.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160112
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - AIM
SB  - IM
CIN - Chest. 2016 Feb;149(2):295-7. PMID: 26867825
CIN - Am J Respir Crit Care Med. 2015 Dec 15;192(12 ):1514-6. PMID: 26502198
MH  - Cardiac Catheterization
MH  - Exercise/*physiology
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/*physiopathology
MH  - Pulmonary Circulation/*physiology
MH  - Pulmonary Wedge Pressure/*physiology
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Time Factors
MH  - *Vascular Resistance
OTO - NOTNLM
OT  - exercise
OT  - hemodynamics
OT  - pulmonary arterial hypertension
OT  - pulmonary hypertension
EDAT- 2015/07/03 06:00
MHDA- 2016/06/22 06:00
CRDT- 2015/07/03 06:00
PHST- 2015/07/03 06:00 [entrez]
PHST- 2015/07/03 06:00 [pubmed]
PHST- 2016/06/22 06:00 [medline]
AID - S0012-3692(15)00118-X [pii]
AID - 10.1378/chest.15-0125 [doi]
PST - ppublish
SO  - Chest. 2016 Feb;149(2):353-361. doi: 10.1378/chest.15-0125. Epub 2016 Jan 12.