Table 2.
Resting haemodynamics and integrated cardiopulmonary function
| Control subjects (n = 69) | IpcPH (n = 55) | CpcPH (n = 40) | P-value | |
|---|---|---|---|---|
| Vital signs | ||||
| Heart rate (b.p.m.) | 72 ± 12 | 76 ± 20 | 71 ± 15 | 0.2 |
| Systolic BP (mmHg) | 142 ± 22 | 156 ± 23* | 149 ± 28 | 0.009 |
| Mean BP (mmHg) | 95 ± 12 | 104 ± 13* | 97 ± 16 | 0.002 |
| Ventricular filling pressures | ||||
| RAP (mmHg) | 5 ± 2 | 12 ± 4* | 15 ± 5*,** | <0.0001 |
| PAWP (mmHg) | 8 ± 3 | 20 ± 3* | 23 ± 4*,** | <0.0001 |
| PAWP V wave (mmHg) | 10 ± 4 | 26 ± 6* | 34 ± 11*,** | <0.0001 |
| RAP/PAWP ratio | 0.67 ± 0.25 | 0.62 ± 0.18 | 0.66 ± 0.19 | 0.5 |
| LVTMP (mmHg) | 2 (1, 4) | 7 (4, 10)* | 8 (4, 11)* | <0.0001 |
| Pulmonary circulation | ||||
| PA systolic pressure (mmHg) | 25 ± 5 | 42 ± 10* | 67 ± 18*,** | <0.0001 |
| PA diastolic pressure (mmHg) | 10 ± 3 | 20 ± 5* | 27 ± 6*,** | <0.0001 |
| PA mean pressure (mmHg) | 16 ± 3 | 29 ± 6* | 44 ± 9*,** | <0.0001 |
| Diastolic pressure gradient (mmHg) | 2 (0, 4) | 1 (-2, 3) | 3 (0, 7) ,** | 0.002 |
| PVR (WU) | 1.5 (1.2, 2.0) | 1.6 (1.2, 2.1) | 4.8 (3.8, 7.5)*,** | <0.0001 |
| PAC (mL/mmHg) | 5.2 ± 1.8 | 4.0 ± 1.6* | 1.6 ± 0.7*,** | <0.0001 |
| Oxygen transport | ||||
| VO2 (mL/min/kg) | 2.7 ± 0.8 | 2.7 ± 0.6 | 2.5 ± 0.6 | 0.2 |
| QT (L/min) | 5.5 ± 1.4 | 5.9 ± 1.5 | 3.9 ± 1.2*,** | <0.0001 |
| AVO2 diff (mL/dL) | 4.1 ± 0.7 | 4.6 ± 1.0* | 5.6 ± 1.2*,** | <0.0001 |
| DO2 (mL/min) | 909 ± 256 | 926 ± 226 | 583 ± 191*,* | <0.0001 |
| VO2/DO2 | 0.25 ± 0.04 | 0.28 ± 0.05* | 0.38 ± 0.09*,* | <0.0001 |
| Pulmonary function and gas exchange | ||||
| VE (L/min) | 7.8 ± 3.8 | 8.4 ± 2.8 | 6.9 ± 1.9 | 0.1 |
| VT (mL) | 500 (389, 633) | 493 (409, 619) | 451 (378, 539) | 0.3 |
| Respiratory rate (/min) | 15 ± 5 | 16 ± 5 | 16 ± 5 | 0.4 |
| V̇A (L/min) | 4.7 ± 2.5 | 4.9 ± 1.6 | 3.9 ± 1.0 | 0.08 |
| VD/VT | 0.39 ± 0.09 | 0.41 ± 0.08 | 0.45 ± 0.08* | 0.02 |
| Physiologic shunt fraction | 0.05 (0, 0.10) | 0.08 (0, 0.16) | 0.09 (0.05, 0.14) | 0.3 |
| DLO2 (mL/min/mmHg) | 9 (5, 19) | 9 (7, 11) | 8 (6, 13) | 0.6 |
| PAO2 (mmHg) | 94 ± 18 | 97 ± 19 | 93 ± 16 | 0.6 |
| Arterial SaO2 (%) | 96 ± 2 | 95 ± 3* | 93 ± 5*,* | <0.0001 |
| Arterial pO2 (mmHg) | 79 ± 14 | 72 ± 12* | 67 ± 13* | 0.0001 |
| Arterial pCO2 (mmHg) | 37 ± 6 | 40 ± 5 | 40 ± 7 | 0.03 |
| PA SvO2 (%) | 72 ± 5 | 68 ± 5 | 58 ± 9*,* | <0.0001 |
| PA pO2 (mmHg) | 39 ± 7 | 36 ± 3 | 32 ± 5*,* | <0.0001 |
| PA pCO2 (mmHg) | 39 ± 5 | 42 ± 6 | 44 ± 6* | 0.0009 |
| Alveolar–arterial O2 gradient (mmHg) | 15 (2, 32) | 29 (18, 35)* | 29 (15, 35)* | 0.005 |
| Right heart function | ||||
| RV s′ (cm/s) | 11 ± 3 | 10 ± 3 | 8 ± 3*,** | <0.0001 |
| TAPSE (mm) | 20 ± 5 | 18 ± 5 | 14 ± 5*,** | <0.0001 |
| RV FAC (%) | 45 ± 7 | 42 ± 9 | 35 ± 9*,** | <0.0001 |
| RV s′/systolic PA (cm/s*mm Hg) | 0.47 ± 0.19 | 0.25 ± 0.10* | 0.12 ± 0.06*,** | <0.0001 |
| TAPSE/systolic PA (mm/mm Hg) | 0.82 ± 0.27 | 0.45 ± 0.16* | 0.22 ± 0.10*,** | <0.0001 |
| FAC/systolic PA (%/mm Hg) | 1.85 ± 0.49 | 1.06 ± 0.35* | 0.57 ± 0.25*,** | <0.0001 |
| Ventricular interaction | ||||
| Eccentricity index at end diastole | 1.06 ± 0.12 | 1.08 ± 0.15 | 1.12 ± 0.16 | 0.1 |
| Eccentricity index at end systole | 0.96 ± 0.09 | 1.01 ± 0.06 | 1.14 ± 0.18*,** | <0.0001 |
| Pulmonary congestion | ||||
| Number of B-lines | 0 (0–0) | 0 (0–2)* | 2 (0–5)* | <0.0001 |
Data are mean ± SD, median (interquartile range), or n (%). Final column reflects overall group differences.
AVO2 diff, arterial-venous O2 content difference; BP, blood pressure; CpcPH, combined post- and pre-capillary pulmonary hypertension; DLO2, estimated pulmonary diffusing capacity for oxygen; DO2, oxygen delivery; FAC, fractional area change; IpcPH, isolated post-capillary pulmonary hypertension; LHD, left heart disease; LVTMP, left ventricular transmural pressure; LV, left ventricular; PA, pulmonary artery; PAC, pulmonary artery compliance; PAWP, pulmonary artery wedge pressure; PAO2, alveolar oxygen tension; PA-aO2, alveolar-to-arterial O2 gradient; PVR, pulmonary vascular resistance; RAP, right atrial pressure; QT, cardiac output; RV, right ventricular; s′, systolic tissue doppler velocity; SaO2, arterial oxygen saturation; TAPSE, tricuspid annular plane systolic excursion; V̇A, alveolar ventilation; VD, pulmonary dead space; VE, minute ventilation; VT, tidal volume; , carbon dioxide volume; VO2, oxygen consumption volume.
*P < 0.05 vs. controls, **P < 0.05 vs. IpcPH groups.