Exercise Pulmonary Hypertension

The clinical value of pulmonary hemodynamics during exercise has not been fully explored. In the last decade, several studies investigated the prognostic and diagnostic relevance of exercise hemodynamics and novel hemodynamic variables including the mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope and the pulmonary arterial wedge pressure (PAWP)/CO slope have been analyzed. These parameters describe the effects of pulmonary blood flow on the pulmonary pressure and were shown to be of prognostic relevance. In addition, they may also serve as tools to differentiate early forms of pulmonary vascular from left heart diseases. Right heart catheterization remains the gold standard to assess pulmonary hemodynamics both at rest and during exercise, while exercise echocardiography represents a promising non-invasive research tool. In this review, we provide an overview of the growing body of evidence on the clinical relevance of pulmonary hemodynamics during exercise and discuss its potential future role.