Exercise-induced desaturation during a six-minute walk test is associated with poor clinical outcomes in patients with pulmonary arterial hypertension

Background The six-minute walk test (6MWT) is an established exercise test for patients with pulmonary arterial hypertension (PAH), affording insight into both exercise intolerance and overall prognosis. Despite the widespread application of the 6MWT, the prognostic implications of exercise-induced...

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Published in:Clinical hypertension Vol. 29; no. 1; pp. 1 - 8
Main Authors: Choi, Jung Hyun, Shin, Myung-Jun, Lee, Byeong-Ju, Park, Jae-Hyeong
Format: Journal Article
Language:English
Published: London BioMed Central 01.12.2023
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Subjects:
6-min walk test
Angiology
Carbon
Cardiac catheterization
Cardiology
Chronic obstructive pulmonary disease
Clinical outcomes
Desaturation
Dyspnea
Exercise
Heart
Intubation
Lung transplants
Medical prognosis
Medicine
Medicine & Public Health
Oxygen saturation
Physical fitness
Prognosis
Pulmonary arterial hypertension
Pulmonary arteries
Pulmonary hypertension
Ventilation
내과학
Rome Italy
Italy
Pulmonary arterial hypertension
Prognosis
6-min walk test
Desaturation
ISSN:2056-5909, 1342-2154, 2635-6325, 2056-5909
Online Access:Get full text
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Summary:Background The six-minute walk test (6MWT) is an established exercise test for patients with pulmonary arterial hypertension (PAH), affording insight into both exercise intolerance and overall prognosis. Despite the widespread application of the 6MWT, the prognostic implications of exercise-induced desaturation (EID) during this test has been inadequately studied in PAH patients. Thus, we evaluated the occurrence of EID and its prognostic significance in PAH patients. Methods We analyzed PAH patients in a single-center cohort from April 2016 to March 2021. EID was defined as a reduction in oxygen saturation exceeding 4% from the baseline or to below 90% at any point during the test. Results We analyzed 20 PAH patients in this cohort, primarily consisting of 16 females with an average age of 48.4 ± 13.3 years. Among them, ten exhibited EID. Baseline characteristics, echocardiographic data and right heart catheterization data were similar between the two groups. However, total distance (354.3 ± 124.4 m vs. 485.4 ± 41.4 m, P  = 0.019) and peak oxygen uptake (12.9 ± 3.2 mL/kg⋅min vs. 16.4 ± 3.6 mL/kg⋅min, P  = 0.019) were significantly lower in the EID group. During the total follow-up duration of 51.9 ± 25.7 months, 17 patients had at least one adverse clinical event (2 deaths, 1 lung transplantation, and 13 hospital admissions). The presence of EID was associated with poor clinical outcome (hazard ratio = 6.099, 95% confidence interval = 1.783–20.869, P  = 0.004). Conclusions During the 6MWT, EID was observed in a half of PAH patients and emerged as a significant prognostic marker for adverse clinical events. Graphical Abstract
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https://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-023-00256-3
ISSN:2056-5909
1342-2154
2635-6325
2056-5909
DOI:10.1186/s40885-023-00256-3