PMID- 26677941
OWN - NLM
STAT- MEDLINE
DCOM- 20170209
LR  - 20170209
IS  - 1399-3003 (Electronic)
IS  - 0903-1936 (Linking)
VI  - 47
IP  - 4
DP  - 2016 Apr
TI  - Age-related upper limits of normal for maximum upright exercise pulmonary
      haemodynamics.
PG  - 1179-88
LID - 10.1183/13993003.01307-2015 [doi]
AB  - The exercise definition of pulmonary hypertension was eliminated from the
      pulmonary hypertension guidelines in part due to uncertainty of the upper limits 
      of normal (ULNs) for exercise haemodynamics in subjects >50 years old.The present
      study, therefore, evaluated the pulmonary haemodynamic responses to maximum
      upright incremental cycling exercise in consecutive subjects who underwent an
      invasive cardiopulmonary exercise testing for unexplained exertional intolerance,
      deemed normal based on preserved exercise capacity and normal resting supine
      haemodynamics. Subjects aged >50 years old (n=41) were compared with subjects
      </=50 years old (n=25). ULNs were calculated as mean + 2 sdPeak exercise mean
      pulmonary arterial pressure was not different for subjects >50 and </=50 years
      old (23 +/- 5 versus 22 +/- 4 mmHg, p=0.22), with ULN of 33 and 30 mmHg,
      respectively. Peak cardiac output was lower in older subjects (median
      (interquartile range): 12.1 (9.4-14.2)versus16.2 (13.8-19.2) L.min(-1), p<0.001).
      Peak pulmonary vascular resistance was higher in older subjects compared with
      younger subjects (mean +/- sd: 1.20 +/- 0.45 versus 0.82 +/- 0.26 Wood units,
      p<0.001), with ULN of 2.10 and 1.34 Wood units, respectively.We observed that
      subjects >50 and </= 50 years old have different pulmonary vascular responses to 
      exercise. Older subjects have higher pulmonary vascular resistance at peak
      exercise, resulting in different exercise haemodynamics ULNs compared with the
      younger population.
CI  - Copyright (c)ERS 2016.
FAU - Oliveira, Rudolf K F
AU  - Oliveira RK
AD  - Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and
      Women's Hospital and Harvard Medical School, Boston, MA, USA Heart and Vascular
      Center, Brigham and Women's Hospital, Boston, MA, USA Division of Respiratory
      Diseases, Dept of Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo,
      SP, Brazil These authors contributed equally to the study.
FAU - Agarwal, Manyoo
AU  - Agarwal M
AD  - Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and
      Women's Hospital and Harvard Medical School, Boston, MA, USA Heart and Vascular
      Center, Brigham and Women's Hospital, Boston, MA, USA These authors contributed
      equally to the study.
FAU - Tracy, Julie A
AU  - Tracy JA
AD  - Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and
      Women's Hospital and Harvard Medical School, Boston, MA, USA Heart and Vascular
      Center, Brigham and Women's Hospital, Boston, MA, USA.
FAU - Karin, Abbey L
AU  - Karin AL
AD  - Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and
      Women's Hospital and Harvard Medical School, Boston, MA, USA Heart and Vascular
      Center, Brigham and Women's Hospital, Boston, MA, USA.
FAU - Opotowsky, Alexander R
AU  - Opotowsky AR
AD  - Heart and Vascular Center, Brigham and Women's Hospital, Boston, MA, USA Dept of 
      Cardiology, Boston Children's Hospital, Boston, MA, USA Division of
      Cardiovascular Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, 
      MA, USA.
FAU - Waxman, Aaron B
AU  - Waxman AB
AD  - Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and
      Women's Hospital and Harvard Medical School, Boston, MA, USA Heart and Vascular
      Center, Brigham and Women's Hospital, Boston, MA, USA.
FAU - Systrom, David M
AU  - Systrom DM
AD  - Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Brigham and
      Women's Hospital and Harvard Medical School, Boston, MA, USA Heart and Vascular
      Center, Brigham and Women's Hospital, Boston, MA, USA dsystrom@partners.org.
LA  - eng
GR  - 2R01HL060234-12A1/HL/NHLBI NIH HHS/United States
GR  - U01HL125215-01/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20151217
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arterial Pressure
MH  - Bicycling
MH  - Cardiac Output
MH  - Exercise/*physiology
MH  - Exercise Test/methods
MH  - Exercise Tolerance/physiology
MH  - Female
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Hypertension, Pulmonary/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Oxygen Consumption
MH  - Pulmonary Artery
MH  - Rest
MH  - Stroke Volume
MH  - Vascular Resistance/physiology
EDAT- 2015/12/19 06:00
MHDA- 2017/02/10 06:00
CRDT- 2015/12/19 06:00
PHST- 2015/08/06 00:00 [received]
PHST- 2015/10/31 00:00 [accepted]
PHST- 2015/12/19 06:00 [entrez]
PHST- 2015/12/19 06:00 [pubmed]
PHST- 2017/02/10 06:00 [medline]
AID - 13993003.01307-2015 [pii]
AID - 10.1183/13993003.01307-2015 [doi]
PST - ppublish
SO  - Eur Respir J. 2016 Apr;47(4):1179-88. doi: 10.1183/13993003.01307-2015. Epub 2015
      Dec 17.