Cardiopulmonary Exercise Testing and Pulmonary Function Testing for Predicting Aggravation of CTEPH

Abstract BackgroundCardiopulmonary exercise testing (CPET) and pulmonary function testing (PFT) are noninvasive methods to evaluate the respiratory and circulatory systems. This research aimed to evaluate and monitor chronic thromboembolic pulmonary hypertension (CTEPH) noninvasively and effectively. At the same time assess the predictive value of CPET and PFT parameters for the aggravation of CTEPH. MethodsWe used data from 86 CTEPH patients (55 for test set, and 31 for validation set) at the Shanghai Pulmonary Hospital Affiliated to Tongji University. The clinical, PFT and CPET parameters of mild, moderate and severe CPET patients classified according to PAP (mm Hg) were compared. Logistic regression analysis was performed to appraise the predictive value of each potential predictor for severe CTEPH. The performance of PFT and CPET parameters for predicting severe CTEPH was determined by receiver operating characteristic (ROC) curves and calibration curves.ResultsData showed that Load @ Peak (W), FEV1/FVC (%), and VE @ AT (L/min) were independent risk factors for severe CTEPH classified according to PAP (mm Hg). Additionally, the efficacy of the use of Load @ Peak (W), FEV1/FVC (%) and VE @ AT (L/min) in identifying severe CTEPH was found to be moderate with area under the curve (AUC) of ROC curves of 0.736, 0.696 and 0.769, respectively. Furthermore, combination with Load @ Peak (W), FEV1/FVC (%) and VE @ AT (L/min) had a moderate utility value in identifying severe CTEPH with an AUC of 0.897.ConclusionOur data suggests that PFT and CPET parameters can noninvasively and effectively evaluate, monitor and predict the aggravation of CTEPH.