Impaired systemic oxygen extraction in treated exercise pulmonary hypertension: a new engine in an old car?

Mariana Faria-Urbina; Rudolf K F Oliveira; Sergio A Segrera; Laurie Lawler; Aaron B Waxman; David M Systrom

doi:10.1177/2045893218755325

Impaired systemic oxygen extraction in treated exercise pulmonary hypertension: a new engine in an old car?

Pulm Circ. 2018 Jan-Mar;8(1):2045893218755325. doi: 10.1177/2045893218755325. Epub 2018 Jan 8.

Authors

Mariana Faria-Urbina^{1

2}, Rudolf K F Oliveira^{1

2

3}, Sergio A Segrera^{1

2}, Laurie Lawler^{1

2}, Aaron B Waxman^{1

2}, David M Systrom^{1

2}

Affiliations

¹ 1 Division of Pulmonary and Critical Care Medicine, 1861 Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
² 2 Heart & Vascular Center, Brigham and Women's Hospital, Boston, MA, USA.
³ 3 Division of Respiratory Diseases, Department of Medicine, 28105 Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.

Abstract

Ambrisentan in 22 patients with pulmonary hypertension diagnosed during exercise (ePH) improved pulmonary hemodynamics; however, there was only a trend toward increased maximum oxygen uptake (VO₂max) secondary to decreased maximum exercise systemic oxygen extraction (Ca-vO₂). We speculate that improved pulmonary hemodynamics at maximum exercise "unmasked" a pre-existing skeletal muscle abnormality.

Keywords: ambrisentan; exercise; pulmonary hypertension; systemic oxygen extraction.