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Ventilatory efficiency in pulmonary vascular diseases

机译：肺血管疾病的通气效率

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Cardiopulmonary exercise testing (CPET) is a frequently used tool in the differential diagnosis of dyspnoea. Ventilatory inefficiency, defined as high minute ventilation ( V′ E ) relative to carbon dioxide output ( V′ CO 2 ), is a hallmark characteristic of pulmonary vascular diseases, which contributes to exercise intolerance and disability in these patients. The mechanisms of ventilatory inefficiency are multiple and include high physiologic dead space, abnormal chemosensitivity and an altered carbon dioxide (CO 2 ) set-point. A normal V′ E / V′ CO 2 makes a pulmonary vascular disease such as pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) unlikely. The finding of high V′ E /V′ CO 2 without an alternative explanation should prompt further diagnostic testing to exclude PAH or CTEPH, particularly in patients with risk factors, such as prior venous thromboembolism, systemic sclerosis or a family history of PAH. In patients with established PAH or CTEPH, the V′ E / V′ CO 2 may improve with interventions and is a prognostic marker. However, further studies are needed to clarify the added value of assessing ventilatory inefficiency in the longitudinal follow-up of patients.
机译：心肺运动试验（CPET）是常用诊断呼吸困难诊断的常用工具。通气效率低下，定义为相对于二氧化碳输出的高分微小通风（V'e）（V'CO 2），是肺血管疾病的标志性特征，有助于在这些患者中运动不耐受和残疾。通气效率低下的机制是多个，包括高生理死亡空间，异常化学敏感性和改变的二氧化碳（CO 2）设定点。普通V'E / V'CO 2使肺动脉疾病如肺动脉高压（PAH）或慢性血栓栓塞肺动脉高血压（CTEPH）不太可能。没有替代解释的高V'E / V'CO 2的发现应促进进一步的诊断测试，以排除PAH或CTEPH，特别是在患有危险因素的患者中，例如现有的静脉血栓栓塞，全身性硬化症或PAH家族史。在已建立的PAH或CTEPH患者中，V'E / V'CO 2可以通过干预改善，并且是预后标记物。然而，需要进一步的研究来阐明评估患者纵向随访的通气效率低下的附加值。

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