Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism
ABSTRACT Although current guidelines recommend standard cardiopulmonary exercise testing (CPET) to evaluate symptomatic patients after pulmonary embolism (PE), CPET with simultaneous echocardiography could provide relevant information to evaluate right ventricular–pulmonary arterial coupling. The ai...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Pulmonary Circulation |
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| Online Access: | https://doi.org/10.1002/pul2.70045 |
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| author | Karys Khilzi Lucilla Piccari Gerard Franco Anna Rodó‐Pin Anna Herranz Isabel Blanco Giuseppe Paciocco Lorenzo Volpiano Jose Gonzalez Garcia Ana Diez‐Llaneza Lluis Molina Diego A. Rodríguez Chiaradía |
| author_facet | Karys Khilzi Lucilla Piccari Gerard Franco Anna Rodó‐Pin Anna Herranz Isabel Blanco Giuseppe Paciocco Lorenzo Volpiano Jose Gonzalez Garcia Ana Diez‐Llaneza Lluis Molina Diego A. Rodríguez Chiaradía |
| author_sort | Karys Khilzi |
| collection | DOAJ |
| description | ABSTRACT Although current guidelines recommend standard cardiopulmonary exercise testing (CPET) to evaluate symptomatic patients after pulmonary embolism (PE), CPET with simultaneous echocardiography could provide relevant information to evaluate right ventricular–pulmonary arterial coupling. The aim of this study was to investigate exercise‐induced changes in echocardiographic variables of RV function or RV– arterial coupling in patients with residual thrombotic defects at 3 months after PE. This retrospective study investigated patients with residual thromboembolic disease on V/Q scintigraphy with persistent symptoms despite adequate anticoagulation after 3 months of acute PE, and resting echocardiography with a low probability of PH. At rest and during exercise, CPET and doppler echocardiography were performed following a standard protocol. Forty‐five patients were included, completing a follow‐up period of at least 24 months. The mean (standard deviation) age was 63 (15) years, and 24 (53%) patients were male. Four patients developed CTEPH after 2 years follow up. Correlation analyses showed that the peak TAPSE was significantly associated with peak workload (r = 0.454, p = 0.003), peak VO2 (r = 0.558, p < 0.001), VE/VECO2 (AT) (r = −0.531, p < 0.001), and oxygen pulse (r = 0.375, p = 0.02). TAPSE/PASP was only slightly associated with peak workload (r = 0.300, p = 0.045). By contrast, the change on TAPSE (from rest to peak) was significantly correlate with peak oxygen uptake (r = 0.491, p = 0.01). Also, reduced VO2 at AT and TAPSE/PASP was seen in patients with CTEPH. CPET with synchronic echocardiography could be a useful tool in early assessment of symptomatic patients with perfusion defects on imaging after 3 months of correctly treated PE. |
| format | Article |
| id | doaj-art-527ea43fc3d54b628f22073bde10f617 |
| institution | OA Journals |
| issn | 2045-8940 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj-art-527ea43fc3d54b628f22073bde10f6172025-08-20T01:50:07ZengWileyPulmonary Circulation2045-89402025-01-01151n/an/a10.1002/pul2.70045Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary EmbolismKarys Khilzi0Lucilla Piccari1Gerard Franco2Anna Rodó‐Pin3Anna Herranz4Isabel Blanco5Giuseppe Paciocco6Lorenzo Volpiano7Jose Gonzalez Garcia8Ana Diez‐Llaneza9Lluis Molina10Diego A. Rodríguez Chiaradía11Pulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainPulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainDepartment of Medicine and Life Sciences (MELIS) Universitat Pompeu Fabra (UPF) Barcelona SpainPulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainPulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainDepartment of Pulmonary Medicine, Hospital Clínic‐Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) University of Barcelona Barcelona SpainDipartimento Cardio‐Toraco‐Vascolare Fondazione IRCCS San Gerardo dei Tintori Università Milano Bicocca Monza (MB) Monza ItalyDipartimento Cardio‐Toraco‐Vascolare Fondazione IRCCS San Gerardo dei Tintori Università Milano Bicocca Monza (MB) Monza ItalyPulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainPulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainHospital Del Mar Research Institute Barcelona SpainPulmonology Department‐Hospital del Mar Pulmonary Hypertension Unit Barcelona SpainABSTRACT Although current guidelines recommend standard cardiopulmonary exercise testing (CPET) to evaluate symptomatic patients after pulmonary embolism (PE), CPET with simultaneous echocardiography could provide relevant information to evaluate right ventricular–pulmonary arterial coupling. The aim of this study was to investigate exercise‐induced changes in echocardiographic variables of RV function or RV– arterial coupling in patients with residual thrombotic defects at 3 months after PE. This retrospective study investigated patients with residual thromboembolic disease on V/Q scintigraphy with persistent symptoms despite adequate anticoagulation after 3 months of acute PE, and resting echocardiography with a low probability of PH. At rest and during exercise, CPET and doppler echocardiography were performed following a standard protocol. Forty‐five patients were included, completing a follow‐up period of at least 24 months. The mean (standard deviation) age was 63 (15) years, and 24 (53%) patients were male. Four patients developed CTEPH after 2 years follow up. Correlation analyses showed that the peak TAPSE was significantly associated with peak workload (r = 0.454, p = 0.003), peak VO2 (r = 0.558, p < 0.001), VE/VECO2 (AT) (r = −0.531, p < 0.001), and oxygen pulse (r = 0.375, p = 0.02). TAPSE/PASP was only slightly associated with peak workload (r = 0.300, p = 0.045). By contrast, the change on TAPSE (from rest to peak) was significantly correlate with peak oxygen uptake (r = 0.491, p = 0.01). Also, reduced VO2 at AT and TAPSE/PASP was seen in patients with CTEPH. CPET with synchronic echocardiography could be a useful tool in early assessment of symptomatic patients with perfusion defects on imaging after 3 months of correctly treated PE.https://doi.org/10.1002/pul2.70045exercise capacitypost‐PE syndromeright ventricular function |
| spellingShingle | Karys Khilzi Lucilla Piccari Gerard Franco Anna Rodó‐Pin Anna Herranz Isabel Blanco Giuseppe Paciocco Lorenzo Volpiano Jose Gonzalez Garcia Ana Diez‐Llaneza Lluis Molina Diego A. Rodríguez Chiaradía Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism Pulmonary Circulation exercise capacity post‐PE syndrome right ventricular function |
| title | Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism |
| title_full | Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism |
| title_fullStr | Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism |
| title_full_unstemmed | Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism |
| title_short | Cardiopulmonary Exercise Testing With Simultaneous Echocardiography After Pulmonary Embolism |
| title_sort | cardiopulmonary exercise testing with simultaneous echocardiography after pulmonary embolism |
| topic | exercise capacity post‐PE syndrome right ventricular function |
| url | https://doi.org/10.1002/pul2.70045 |
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