Hirashiki, Akihiro; Kondo, Takahisa; Okumura, Takahiro; Kamimura, Yoshihiro;
Nakano, Yoshihisa; Fukaya, Kenji; Sawamura, Akinori; Morimoto, Ryota;
Adachi, Shiro; Takeshita, Kyosuke; Murohara, Toyoaki.

Annals of Noninvasive Electrocardiology, May 2016, Vol. 21 Issue: Number 3
p263-271, 9p;

Abstract: Recently, it has become increasingly recognized
that pulmonary hypertension (PH) is a particularly threatening result
of left‐sided heart disease. However, there have been few
investigations of the impact of cardiopulmonary exercise testing (CPX)
variables on PH in dilated cardiomyopathy (DCM). We evaluated the
usefulness of crucial CPX variables for detecting elevated pulmonary
arterial pressure (PAP) in patients with DCM. Ninety subjects with DCM
underwent cardiac catheterization and CPX at our hospital. Receiver
operator characteristic (ROC) analysis was performed to assess the
ability of CPX variables to distinguish between the presence and
absence of PH. Overall mean values were: mean PAP (mPAP), 18.0 ± 9.6
mmHg; plasma brain natriuretic peptide, 233 ± 295 pg/mL; and left
ventricular ejection fraction, 30.2 ± 11.0%. Patients were allocated to
one of two groups on the basis of mean PAP, namely DCM without PH [mean
PAP (mPAP) <25 mmHg; n= 75] and DCM with PH (mPAP ≥25 mmHg; n= 15). A
cutoff achieved percentage of predicted peak VO2(%PPeak VO2) of 52.5%
was the best predictor of an mPAP ≥25 mmHg in the ROC analysis (area
under curve: 0.911). In the multivariate analysis, %PPeak VO2was the
only significant independent predictor of PH (Wald 6.52, odds ratio
0.892, 95% CI 0.818–0.974; P = 0.011). %PPeak VO2was strongly
associated with the presence of PH in patients with DCM. Taken
together, these findings indicate that CPX variables could be important
for diagnosing PH in patients with DCM.