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Objective: This study intended to explore the relation between heart rate recovery at 1 minutes (HRR1) during the recovery phase of cardiopulmonary exercise test (CPET) and exercise capacity in female systemic lupus erythematosus associated pulmonary arterial hypertension (SLE‐PAH) patients. Methods: Twenty‐one female SLE‐PAH patients underwent right heart catheterization (RHC), pulmonary function test (PFT) and CPET. Forty‐two healthy subjects matched with SLE‐PAH patients in age, sex and BMI were recruited as a control group. The correlations between HRR1 with clinical and CPET parameters were performed. Results: Peak HR, ΔHR, HRR1, Peak HR‐warm HR1min, Peak HR‐warm HR2min and CR were significantly lower in SLE‐PAH than in controls (P < .01). Increased incidence of CRI was seen in SLE‐PAH. Except for the Peak PETO2, which was higher in controls, all other CPET parameters were lower in SLE‐PAH. SLE‐PAH patients with HRR1 ≥ 16 had longer 6MWD, lower NT‐proBNP, better percent of predicted gas transfer index or diffusing capacity for carbon monoxide (DLco% pred) as well as better CO and CI. Peak HR, ΔHR, HRR1, Peak HR‐warm HR1min, Peak HR‐warm HR2min, CR, Peak Load, Peak VO2, Peak PETCO2, OUEP and OUES were lower and duration of exercise was shorter in patients with HRR1 < 16. HRR1 had positive correlation with 6MWD, DLco% pred, CO, CI and some key CPET parameters. Conclusions: HRR1 is an easily obtained auxiliary parameter in SLE‐PAH patients to reflect an altered autonomic tone. SLE‐PAH patients with HRR1 < 16 have more severe hemodynamics, worse clinical findings and marked oxygen uptake inefficiency than those with HRR1 ≥ 16. [ABSTRACT FROM AUTHOR]

Background: Acute vasoreactivity testing (AVT) which reflects the compliance of the pulmonary vascular bed has been proven to be of prognostic value. The purpose of the present study is to explore the sex differences of hemodynamics during the AVT and their impact on event‐free survival in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: Eighty‐six patients underwent a right heart catheterization and AVT at Shanghai Pulmonary Hospital from February 2009 to February 2018. Univariate and multiple stepwise regression analysis were performed to determine the predictors of independent event‐free survival, and receiver operating characteristic curve was plotted to determine the cut‐off value of independent parameters in CTEPH. Results: There were no significant differences in both demographics and hemodynamics between male and female patients with CTEPH. Except ΔPVR/PVR showed a significantly higher difference in female than male patients (P = 0.034). Male patients had higher mRAP of pre‐ and post‐AVT than female patients in the event‐free subgroup, while, female patients showed higher PVR of pre‐AVT than male patients in the event subgroup (P < 0.05). The mRAP and SvO2 were independent predictors of event‐free survival in female patients both before and after the AVT, whereas ΔSvO2 was an independent predictor of event‐free survival in male patients. Conclusion: Hemodynamics during the AVT varied between male and female patients with CTEPH. Both sexes displayed unique hemodynamic responses that were independently able to predict event‐free survival. Therefore, better estimates of prognosis in CTEPH can be made when sex differences are also taken into consideration. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension patients with mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg had impaired cardiopulmonary exercise testing (CPET). Borderline mean pulmonary pressures (boPAP; 21‐24 mm Hg) represent early pulmonary vasculopathy. The CPET characteristics of boPAP are a matter of discussion. We aimed to determine the CPET profile of such borderline hemodynamics. Methods: A matched case‐control study was conducted on consecutive boPAP patients at the Shanghai Pulmonary Hospital between Jan 2012 and Jan 2017. Hemodynamics, echocardiography, the pulmonary function test (PFT) and CPET parameters were compared between boPAP patients and normal mPAP patients which were matched 1:1 by sex and age. Conditional logistic regression analysis was performed to determine the efficacy of CPET in detecting boPAP. Results: A total of 48 patients underwent RHC and CPET (24 Normal, 24 boPAP). There were no differences in the demographics, echocardiography and PFT. BoPAP patients had significantly decreased VO2 at the anaerobic threshold and peak VO2/kg (858.4 ± 246.5 mL/min vs 727.9 ± 228.0 mL/min, P = 0.037; 21.1 ± 6.4 mL/min/kg vs. 15.5 ± 5.6 mL/min/kg, P = 0.001, respectively). Significant differences were not observed in ventilation efficiency. A trend of impaired oxygen pulse and submaximal exercise tolerance were observed in boPAP patients. Conditional logistical regression analysis revealed the risk of boPAP increased by 2.493 (95% confident interval: 1.388 to 4.476, P = 0.002) with every 5 mL/min/kg decrease in peak VO2/kg. Conclusions: Patients with boPAP have a greater prevalence of exercise intolerance, a trend of impaired oxygen pulse and submaximal exercise tolerance. [ABSTRACT FROM AUTHOR]