Resting pulmonary artery pressure of 21-24 mmHg predicts abnormal exercise haemodynamics.
Identifieur interne : 001806 ( Main/Exploration ); précédent : 001805; suivant : 001807Resting pulmonary artery pressure of 21-24 mmHg predicts abnormal exercise haemodynamics.
Auteurs : Edmund M T. Lau [Australie] ; Laurent Godinas ; Olivier Sitbon [France] ; David Montani [France] ; Laurent Savale [France] ; Xavier Jaïs [France] ; Frederic Lador [France] ; Sven Gunther [France] ; David S. Celermajer [Australie] ; Gérald Simonneau [France] ; Marc Humbert [France] ; Denis Chemla [France] ; Philippe Herve [France]Source :
- The European respiratory journal [ 1399-3003 ] ; 2016.
Abstract
A resting mean pulmonary artery pressure (mPAP) of 21-24 mmHg is above the upper limit of normal but does not reach criteria for the diagnosis of pulmonary hypertension (PH). We sought to determine whether an mPAP of 21-24 mmHg is associated with an increased risk of developing an abnormal pulmonary vascular response during exercise.Consecutive patients (n=290) with resting mPAP <25 mmHg who underwent invasive exercise haemodynamics were analysed. Risk factors for pulmonary vascular disease or left heart disease were present in 63.4% and 43.8% of subjects. An abnormal pulmonary vascular response (or exercise PH) was defined by mPAP >30 mmHg and total pulmonary vascular resistance >3 WU at maximal exercise.Exercise PH occurred in 74 (86.0%) out of 86 versus 96 (47.1%) out of 204 in the mPAP of 21-24 mmHg and mPAP <21 mmHg groups, respectively (OR 6.9, 95% CI: 3.6-13.6; p<0.0001). Patients with mPAP of 21-24 mmHg had lower 6-min walk distance (p=0.002) and higher New York Heart Association functional class status (p=0.03). Decreasing levels of mPAP were associated with a lower prevalence of exercise PH, which occurred in 60.3%, 38.7% and 7.7% of patients with mPAP of 17-20, 13-16 and <13 mmHg, respectively.In an at-risk population, a resting mPAP between 21-24 mmHg is closely associated with exercise PH together with worse functional capacity.
DOI: 10.1183/13993003.01684-2015
PubMed: 26965292
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Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Godinas, Laurent" sort="Godinas, Laurent" uniqKey="Godinas L" first="Laurent" last="Godinas">Laurent Godinas</name><affiliation><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium Both authors contributed equally.</nlm:affiliation><wicri:noCountry code="subField">Belgium Both authors contributed equally</wicri:noCountry></affiliation></author><author><name sortKey="Sitbon, Olivier" sort="Sitbon, Olivier" uniqKey="Sitbon O" first="Olivier" last="Sitbon">Olivier Sitbon</name><affiliation wicri:level="1"><nlm:affiliation>Univ. 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Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Savale, Laurent" sort="Savale, Laurent" uniqKey="Savale L" first="Laurent" last="Savale">Laurent Savale</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Jais, Xavier" sort="Jais, Xavier" uniqKey="Jais X" first="Xavier" last="Jaïs">Xavier Jaïs</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Lador, Frederic" sort="Lador, Frederic" uniqKey="Lador F" first="Frederic" last="Lador">Frederic Lador</name><affiliation wicri:level="1"><nlm:affiliation>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Gunther, Sven" sort="Gunther, Sven" uniqKey="Gunther S" first="Sven" last="Gunther">Sven Gunther</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Celermajer, David S" sort="Celermajer, David S" uniqKey="Celermajer D" first="David S" last="Celermajer">David S. Celermajer</name><affiliation wicri:level="4"><nlm:affiliation>Sydney Medical School, University of Sydney, Camperdown, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Medical School, University of Sydney, Camperdown</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Simonneau, Gerald" sort="Simonneau, Gerald" uniqKey="Simonneau G" first="Gérald" last="Simonneau">Gérald Simonneau</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Humbert, Marc" sort="Humbert, Marc" uniqKey="Humbert M" first="Marc" last="Humbert">Marc Humbert</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Chemla, Denis" sort="Chemla, Denis" uniqKey="Chemla D" first="Denis" last="Chemla">Denis Chemla</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Herve, Philippe" sort="Herve, Philippe" uniqKey="Herve P" first="Philippe" last="Herve">Philippe Herve</name><affiliation wicri:level="1"><nlm:affiliation>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26965292</idno><idno type="pmid">26965292</idno><idno type="doi">10.1183/13993003.01684-2015</idno><idno type="wicri:Area/PubMed/Corpus">001F47</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001F47</idno><idno type="wicri:Area/PubMed/Curation">001F23</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001F23</idno><idno type="wicri:Area/PubMed/Checkpoint">001F23</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001F23</idno><idno type="wicri:Area/Ncbi/Merge">003263</idno><idno type="wicri:Area/Ncbi/Curation">003263</idno><idno type="wicri:Area/Ncbi/Checkpoint">003263</idno><idno type="wicri:Area/Main/Merge">001801</idno><idno type="wicri:Area/Main/Curation">001806</idno><idno type="wicri:Area/Main/Exploration">001806</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Resting pulmonary artery pressure of 21-24 mmHg predicts abnormal exercise haemodynamics.</title><author><name sortKey="Lau, Edmund M T" sort="Lau, Edmund M T" uniqKey="Lau E" first="Edmund M T" last="Lau">Edmund M T. Lau</name><affiliation wicri:level="4"><nlm:affiliation>Sydney Medical School, University of Sydney, Camperdown, Australia Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France Both authors contributed equally edmund.lau@sydney.edu.au.</nlm:affiliation><country wicri:rule="url">Australie</country><wicri:regionArea>Sydney Medical School, University of Sydney, Camperdown, Australia Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Godinas, Laurent" sort="Godinas, Laurent" uniqKey="Godinas L" first="Laurent" last="Godinas">Laurent Godinas</name><affiliation><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France CHU Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium Both authors contributed equally.</nlm:affiliation><wicri:noCountry code="subField">Belgium Both authors contributed equally</wicri:noCountry></affiliation></author><author><name sortKey="Sitbon, Olivier" sort="Sitbon, Olivier" uniqKey="Sitbon O" first="Olivier" last="Sitbon">Olivier Sitbon</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Montani, David" sort="Montani, David" uniqKey="Montani D" first="David" last="Montani">David Montani</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Savale, Laurent" sort="Savale, Laurent" uniqKey="Savale L" first="Laurent" last="Savale">Laurent Savale</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Jais, Xavier" sort="Jais, Xavier" uniqKey="Jais X" first="Xavier" last="Jaïs">Xavier Jaïs</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Lador, Frederic" sort="Lador, Frederic" uniqKey="Lador F" first="Frederic" last="Lador">Frederic Lador</name><affiliation wicri:level="1"><nlm:affiliation>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Gunther, Sven" sort="Gunther, Sven" uniqKey="Gunther S" first="Sven" last="Gunther">Sven Gunther</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Celermajer, David S" sort="Celermajer, David S" uniqKey="Celermajer D" first="David S" last="Celermajer">David S. Celermajer</name><affiliation wicri:level="4"><nlm:affiliation>Sydney Medical School, University of Sydney, Camperdown, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Medical School, University of Sydney, Camperdown</wicri:regionArea><orgName type="university">Université de Sydney</orgName><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="Simonneau, Gerald" sort="Simonneau, Gerald" uniqKey="Simonneau G" first="Gérald" last="Simonneau">Gérald Simonneau</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Humbert, Marc" sort="Humbert, Marc" uniqKey="Humbert M" first="Marc" last="Humbert">Marc Humbert</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Chemla, Denis" sort="Chemla, Denis" uniqKey="Chemla D" first="Denis" last="Chemla">Denis Chemla</name><affiliation wicri:level="1"><nlm:affiliation>Univ. Paris-Sud, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Univ. Paris-Sud, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author><author><name sortKey="Herve, Philippe" sort="Herve, Philippe" uniqKey="Herve P" first="Philippe" last="Herve">Philippe Herve</name><affiliation wicri:level="1"><nlm:affiliation>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France INSERM UMR_S999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France Dept de Chirurgie Thoracique, Vasculaire et de Transplantation Pulmonaire, Hopital Marie Lannelongue, Le Plessis Robinson</wicri:regionArea><wicri:noRegion>Le Plessis Robinson</wicri:noRegion><wicri:noRegion>Le Plessis Robinson</wicri:noRegion></affiliation></author></analytic><series><title level="j">The European respiratory journal</title><idno type="eISSN">1399-3003</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A resting mean pulmonary artery pressure (mPAP) of 21-24 mmHg is above the upper limit of normal but does not reach criteria for the diagnosis of pulmonary hypertension (PH). We sought to determine whether an mPAP of 21-24 mmHg is associated with an increased risk of developing an abnormal pulmonary vascular response during exercise.Consecutive patients (n=290) with resting mPAP <25 mmHg who underwent invasive exercise haemodynamics were analysed. Risk factors for pulmonary vascular disease or left heart disease were present in 63.4% and 43.8% of subjects. An abnormal pulmonary vascular response (or exercise PH) was defined by mPAP >30 mmHg and total pulmonary vascular resistance >3 WU at maximal exercise.Exercise PH occurred in 74 (86.0%) out of 86 versus 96 (47.1%) out of 204 in the mPAP of 21-24 mmHg and mPAP <21 mmHg groups, respectively (OR 6.9, 95% CI: 3.6-13.6; p<0.0001). Patients with mPAP of 21-24 mmHg had lower 6-min walk distance (p=0.002) and higher New York Heart Association functional class status (p=0.03). Decreasing levels of mPAP were associated with a lower prevalence of exercise PH, which occurred in 60.3%, 38.7% and 7.7% of patients with mPAP of 17-20, 13-16 and <13 mmHg, respectively.In an at-risk population, a resting mPAP between 21-24 mmHg is closely associated with exercise PH together with worse functional capacity.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li></country><region><li>Nouvelle-Galles du Sud</li></region><settlement><li>Sydney</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><noCountry><name sortKey="Godinas, Laurent" sort="Godinas, Laurent" uniqKey="Godinas L" first="Laurent" last="Godinas">Laurent Godinas</name></noCountry><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Lau, Edmund M T" sort="Lau, Edmund M T" uniqKey="Lau E" first="Edmund M T" last="Lau">Edmund M T. Lau</name></region><name sortKey="Celermajer, David S" sort="Celermajer, David S" uniqKey="Celermajer D" first="David S" last="Celermajer">David S. Celermajer</name></country><country name="France"><noRegion><name sortKey="Sitbon, Olivier" sort="Sitbon, Olivier" uniqKey="Sitbon O" first="Olivier" last="Sitbon">Olivier Sitbon</name></noRegion><name sortKey="Chemla, Denis" sort="Chemla, Denis" uniqKey="Chemla D" first="Denis" last="Chemla">Denis Chemla</name><name sortKey="Gunther, Sven" sort="Gunther, Sven" uniqKey="Gunther S" first="Sven" last="Gunther">Sven Gunther</name><name sortKey="Herve, Philippe" sort="Herve, Philippe" uniqKey="Herve P" first="Philippe" last="Herve">Philippe Herve</name><name sortKey="Humbert, Marc" sort="Humbert, Marc" uniqKey="Humbert M" first="Marc" last="Humbert">Marc Humbert</name><name sortKey="Jais, Xavier" sort="Jais, Xavier" uniqKey="Jais X" first="Xavier" last="Jaïs">Xavier Jaïs</name><name sortKey="Lador, Frederic" sort="Lador, Frederic" uniqKey="Lador F" first="Frederic" last="Lador">Frederic Lador</name><name sortKey="Montani, David" sort="Montani, David" uniqKey="Montani D" first="David" last="Montani">David Montani</name><name sortKey="Savale, Laurent" sort="Savale, Laurent" uniqKey="Savale L" first="Laurent" last="Savale">Laurent Savale</name><name sortKey="Simonneau, Gerald" sort="Simonneau, Gerald" uniqKey="Simonneau G" first="Gérald" last="Simonneau">Gérald Simonneau</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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