Table 3.
Exercise Hemodynamics in Upright Position (Main Cohort) and Supine Position (Historical Cohort)
|
Upright exercise cohort (main cohort) |
Supine exercise cohort (historical cohort) |
Unadjusted difference at end‐exercise upright vs supine | Difference at end‐exercise upright vs supine, adjusted for baseline and work rate | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Baseline rest | End‐exercise | Changes from rest to end‐exercise | Baseline rest | End‐exercise | Changes from rest to end‐exercise | Mean difference (95% CI) | P Value | Mean difference (95% CI) | P Value | |
| All patients | n=213 | n=270 | ||||||||
| Work rate, watts | 0 | 53±26 | 53±26 | 0 | 33±22 | 33±22 | 21.3 (17.1 to 25.5) | <0.001 | … | … |
| Heart rate, bpm | 76±13 | 118±22 | 42±21 | 75±13 | 110±19 | 35±18 | 8.2 (4.5 to 11.9) | <0.001 | −1.3 (−4.5 to 1.9) | 0.434 |
| Systolic blood pressure, mm Hg | 140±20 | 165±30 | 25±25 | 129±20† | 158±27 | 30±20 | 6.7 (1.5 to 11.9) | 0.012 | −8.1 (−12.7 to −3.5) | 0.001 |
| Diastolic blood pressure, mm Hg | 81±15 | 82±21 | 1±20 | 76±12† | 84±19 | 8±17 | −2.1 (−5.8 to 1.5) | 0.250 | −4.1 (−7.7 to −0.4) | 0.028 |
| Mean pulmonary artery pressure, mm Hg | 31±14 | 52±19 | 21±11 | 29±12 | 45±16 | 16±9 | 4.0 (2.0 to 5.9) | <0.001 | 2.8 (1.2 to 4.4) | 0.001 |
| Pulmonary artery wedge pressure, mm Hg | 11±4 | 15±6 | 4±4 | 11±4† | 16±7 | 4±5 | −2.0 (−3.0 to −0.9) | <0.001 | −0.4 (−1.4 to 0.6) | 0.442 |
| Right atrial pressure, mm Hg | 7±4 | 12±7 | 5±5 | 7±4 | 11±7 | 4±5 | 0.0 (−1.1 to 1.2) | 0.961 | 1.1 (0.2 to 2.0) | 0.020 |
| Cardiac index, L/min per m2 | 2.9±0.7 | 4.1±1.4 | 1.2±1.2 | 3.1±0.8* | 4.0±1.1 | 0.9±0.8 | 0.2 (−0.0 to 0.5) | 0.054 | −0.0 (−0.2 to 0.2) | 0.885 |
| Pulmonary vascular resistance, WU | 4.1±3.1 | 5.4±3.7 | 1.4±1.9 | 3.4±2.9 | 4.5±3.4 | 1.1±1.4 | 0.6 (0.0 to 1.1) | 0.034 | 0.5 (0.2 to 0.8) | 0.002 |
| mPAP/ cardiac output, WU | 6.4±4.0 | 7.9±4.7 | 1.6±2.4 | 5.6±3.4 | 7.1±4.1 | 1.4±1.7 | 0.3 (−0.4 to 0.9) | 0.391 | 0.6 (0.3 to 1.0) | 0.001 |
| Systemic vascular resistance, WU | 20.4±7.3 | 14.2±6.3 | −5.9±5.5 | 17.0±5.8† | 15.1±5.6 | −1.9±3.8 | −0.9 (−2.1 to 0.2) | 0.108 | −1.7 (−2.6 to −0.8) | <0.001 |
| Precapillary PH | n=120 | n=126 | ||||||||
| Work rate, watts | 0 | 51±26 | 51±26 | 0 | 28±19 | 28+19 | 22.8 (17.1 to 28.6) | <0.001 | … | … |
| Heart rate, bpm | 78±13 | 119±22 | 42±21 | 78±13 | 110±18 | 32±17 | 9.5 (4.4 to 14.5) | <0.001 | −0.1 (−4.4 to 4.1) | 0.948 |
| Systolic blood pressure, mm Hg | 137±19 | 165±30 | 28±26 | 129±20* | 157±27 | 28±20 | 7.0 (−0.2 to 14.3) | 0.055 | −4.9 (−10.9 to 1.0) | 0.106 |
| Diastolic blood pressure, mm Hg | 81±13 | 83±21 | 2±19 | 78±12 | 88±18 | 10±17 | −5.4 (−10.4 to −0.3) | 0.036 | −5.6 (−10.4 to −0.8) | 0.024 |
| Mean pulmonary artery pressure, mm Hg | 38±13 | 63±15 | 25±11 | 38±11 | 57±12 | 19±9 | 6.1 (3.4 to 8.7) | <0.001 | 4.4 (2.3 to 6.5) | <0.001 |
| Pulmonary artery wedge pressure, mm Hg | 11±4 | 14±5 | 3±4 | 11±3 | 16±5 | 4±5 | −1.4 (−2.9 to 0.0) | 0.056 | −0.6 (−2.0 to 0.7) | 0.361 |
| Right atrial pressure, mm Hg | 8±5 | 14±8 | 6±6 | 8±4 | 14±7 | 5±5 | −0.2 (−1.8 to 1.4) | 0.834 | 1.1 (−0.1 to 2.3) | 0.076 |
| Cardiac index, L/min per m2 | 2.8±0.7 | 3.9±1.4 | 1.1±1.1 | 3.0±0.8* | 3.7±1.1 | 0.7±0.7 | 0.2 (−0.1 to 0.5) | 0.226 | −0.1 (−0.3 to 0.1) | 0.295 |
| Pulmonary vascular resistance, WU | 5.7±3.4 | 7.6±3.7 | 1.8±2.3 | 5.4±3.2 | 6.8±3.6 | 1.4±1.7 | 0.8 (0.0 to 1.5) | 0.049 | 0.8 (0.3 to 1.2) | 0.001 |
| mPAP/cardiac output, WU | 8.2±4.4 | 10.2±4.8 | 2.1±2.7 | 7.7±3.8 | 9.5±4.3 | 1.7±2.0 | 0.7 (−0.2 to 1.6) | 0.129 | 1.0 (0.5 to 1.5) | <0.001 |
| Systemic vascular resistance, WU | 20.7±7.5 | 14.5±7.1 | −5.9±5.9 | 17.6±6.4* | 16.0±6.4 | −1.6±3.7 | −1.6 (−3.1 to 0.0) | 0.054 | −2.0 (−3.2 to −0.9) | <0.001 |
| Postcapillary PH | n=24 | n=24 | ||||||||
| Work rate, watts | 0 | 44±24 | 44±24 | 0 | 24±8 | 24±18 | 20.6 (7.4 to 33.8) | 0.002 | … | … |
| Heart rate, bpm | 75±11 | 103±16 | 28±15 | 73±11 | 102±14 | 29±14 | 0.7 (−11.0 to 12.4) | 0.910 | −9.0 (−18.3 to 0.3) | 0.058 |
| Systolic blood pressure, mm Hg | 146±25 | 158±32 | 12±23 | 144±23 | 179±35 | 35±20 | −20.4 (−36.7 to −4.0) | 0.015 | −26.8 (−39.5 to −14.0) | <0.001 |
| Diastolic blood pressure, mm Hg | 78±13 | 76±14 | −2±11 | 76±13 | 87±24 | 12±20 | −10.8 (−22.2 to 0.7) | 0.065 | −11.2 (−21.6 to −0.8) | 0.035 |
| Mean pulmonary artery pressure, mm Hg | 31±9 | 48±10 | 19±8 | 33±8 | 50±11 | 17±8 | −1.9 (−8.0 to 4.2) | 0.541 | 0.2 (−4.5 to 4.8) | 0.949 |
| Pulmonary artery wedge pressure, mm Hg | 15±4 | 23±6 | 8±5 | 18±4 | 27±5 | 8±5 | −4.2 (−7.4 to −1.0) | 0.010 | −0.5 (−3.4 to 2.3) | 0.711 |
| Right atrial pressure, mm Hg | 9±5 | 14±6 | 6±4 | 10±4 | 16±7 | 6±4 | −1.6 (−5.2 to 2.1) | 0.398 | 0.6 (−2.1 to 3.2) | 0.671 |
| Cardiac index, L/min per m2 | 3.0±0.7 | 3.7±1.0 | 0.8±0.8 | 3.4±1.2* | 4.0±1.4 | 0.5±0.4 | −0.3 (−1.10 to 0.4) | 0.402 | −0.2 (−0.7 to 0.2) | 0.365 |
| Pulmonary vascular resistance, WU | 2.7±1.2 | 3.9±2.0 | 1.3±1.5 | 2.5±1.1 | 3.6±1.8 | 1.0±1.1 | 0.4 (−1.3 to 2.0) | 0.654 | 0.5 (−0.4 to 1.4) | 0.269 |
| mPAP/ cardiac output, WU | 5.4±1.6 | 7.1±2.8 | 1.9±2.4 | 5.8±2.0 | 7.7±2.9 | 1.9±1.6 | −0.5 (−2.6 to 1.6) | 0.621 | 0.5 (−0.6 to 1.6) | 0.357 |
| Systemic vascular resistance, WU | 18.9±7.0 | 13.4±5.8 | −4.9±4.5 | 16.0±5.5 | 15.2±4.5 | −0.8±2.5 | −1.8 (−5.4 to 1.8) | 0.327 | −2.3 (−4.7 to 0.1) | 0.062 |
| Exercise PH | n=38 | n=68 | ||||||||
| Work rate, watts | 0 | 56±25 | 56±25 | 0 | 35±19 | 35±19 | 20.7 (11.5 to 29.8) | <0.001 | … | … |
| Heart rate, bpm | 74±11 | 119±22 | 45±23 | 72±12 | 111±21 | 39±19 | 8.0 (−0.1 to 16.1) | 0.052 | −2.8 (−9.3 to 3.8) | 0.406 |
| Systolic blood pressure, mm Hg | 146±19 | 171±34 | 26±28 | 128±19† | 160±24 | 33±22 | 11.0 (−0.4 to 22.3) | 0.059 | −9.4 (−18.6 to −0.3) | 0.044 |
| Diastolic blood pressure, mm Hg | 84±22 | 87±25 | 4±25 | 73±11† | 81±16 | 8±15 | 6.0 (−1.9 to 14.0) | 0.137 | 0.6 (−6.9 to 8.0) | 0.881 |
| Mean pulmonary artery pressure, mm Hg | 20±4 | 39±7 | 19±7 | 20±3 | 37±6 | 17±6 | 2.4 (−1.8 to 6.6) | 0.268 | 0.9 (−2.3 to 4.2) | 0.576 |
| Pulmonary artery wedge pressure, mm Hg | 9±3 | 14±6 | 5±5 | 10±3* | 17±7 | 7±6 | −3.9 (−6.2 to −1.6) | 0.001 | −1.7 (−3.7 to 0.4) | 0.110 |
| Right atrial pressure, mm Hg | 6±3 | 9±5 | 3±3 | 6±3 | 9±5 | 4±4 | −0.7 (−3.2 to 1.8) | 0.592 | 0.1 (−1.7 to 2.0) | 0.886 |
| Cardiac index, L/min per m2 | 2.9±0.8 | 4.2±0.9 | 1.3±0.9 | 3.2±0.8 | 4.1±1.1 | 0.9±0.8 | 0.1 (−0.4 to 0.6) | 0.746 | −0.0 (−0.3 to 0.3) | 0.976 |
| Pulmonary vascular resistance, WU | 2.3±0.9 | 3.5±1.3 | 1.0±1.1 | 1.7±0.7 | 2.8±1.4 | 1.0±1.0 | 0.7 (−0.5 to 1.8) | 0.237 | 0.3 (−0.4 to 0.9) | 0.394 |
| mPAP/ cardiac output, WU | 4.0±1.1 | 5.4±1.6 | 1.3±1.4 | 3.6±1.1 | 5.2±1.8 | 1.6±1.4 | 0.1 (−1.3 to 1.5) | 0.876 | 0.2 (−0.5 to 1.0) | 0.571 |
| Systemic vascular resistance, WU | 21.4±7.4 | 14.7±4.7 | −7.0±6.3 | 16.1±4.7† | 14.2±4.6 | −1.8±4.4 | 0.4 (−2.0 to 2.9) | 0.723 | −2.0 (−3.7 to −0.3) | 0.022 |
| No PH | n=31 | n=52 | ||||||||
| Work rate, watts | 0 | 63±23 | 63±23 | 0 | 45±31 | 45±31 | 18.0 (7.7 to 28.2) | 0.001 | … | … |
| Heart rate, bpm | 73±12 | 123±21 | 49±19 | 74±11 | 114±20 | 40±22 | 8.9 (−0.1 to 17.9) | 0.052 | 1.5 (−5.7 to 8.7) | 0.677 |
| Systolic blood pressure, mm Hg | 141±15 | 165±20 | 23±17 | 124±17† | 149±24 | 26±20 | 15.3 (2.5 to 28.1) | 0.020 | −5.3 (−15.5 to 5.0) | 0.312 |
| Diastolic blood pressure, mm Hg | 80±9 | 77±21 | −3±20 | 74±11* | 75±19 | 2±20 | 1.7 (−7.3 to 10.6) | 0.718 | −1.6 (−9.9 to 6.6) | 0.696 |
| Mean pulmonary artery pressure, mm Hg | 16±4 | 26±6 | 10±4 | 16±3 | 23±4 | 7±4 | 3.2 (−1.6 to 8.0) | 0.187 | 2.1 (−1.5 to 5.7) | 0.260 |
| Pulmonary artery wedge pressure, mm Hg | 8±3 | 11±4 | 3±4 | 9±3 | 11±5 | 2±5 | 0.3 (−2.3 to 2.8) | 0.847 | 1.9 (−0.3 to 4.2) | 0.090 |
| Right atrial pressure, mm Hg | 6±3 | 8±4 | 1±3 | 6±3 | 5±4 | −1±3 | 2.4 (−0.4 to 5.3) | 0.094 | 2.5 (0.5 to 4.6) | 0.017 |
| Cardiac index, L/min per m2 | 3.1±0.7 | 5.1±1.9 | 2.0±1.6 | 3.1±0.7 | 4.3±1.1 | 1.2±0.9 | 0.8 (0.2 to 1.3) | 0.006 | 0.4 (0.0 to 0.7) | 0.034 |
| Pulmonary vascular resistance, WU | 1.6±0.7 | 1.9±0.7 | 0.3±0.7 | 1.5±0.8 | 1.8±0.9 | 0.4±0.6 | 0.1 (−1.2 to 1.3) | 0.916 | 0.1 (−0.6 to 0.9) | 0.699 |
| mPAP/cardiac output, WU | 3.1±1.2 | 3.2±1.2 | 0.8±1.1 | 3.2±1.1 | 3.4±1.5 | 0.2±1.0 | −0.2 (−1.8 to 1.3) | 0.764 | 0.4 (−0.5 to 1.2) | 0.400 |
| Systemic vascular resistance, WU | 18.8±6.4 | 13.3±5.7 | −5.1±3.5 | 17.2±5.6 | 13.8±5.0 | −3.4±3.5 | −0.5 (−3.3 to 2.3) | 0.726 | −0.2 (−2.1 to 1.6) | 0.798 |
Values are expressed as means±SD and mean difference (95% CI). † P<0.001 and *P<0.05 comparison of baseline values in the adjusted regression analysis. mPAP indicates mean pulmonary artery pressure; and WU, Wood units.