2011-9-26肺动脉高压.pptVIP

Introduction Patients with systemic sclerosis (SSc) may develop pulmonary vasculopathy (PV) PV is particularly important since it may lead to pulmonary arterial hypertension (PAH). pulmonary arterial hypertension is a progressive and usually fatal disease Cardiopulmonary exercise testing may help to differentiate and detect PV early Cardiopulmonary exercise testing Cycle ergometry non-rebreathing valve Mouthpiece continuous ECG and blood pressure monitoring Resuscitation equipment on hand( Because the patient can not speakly clearly with the mouthpiece , hand signals are usually used If he or she feel uncomfortable) process 3 minutes of rest, 3 minutes of unloaded leg cycling at 60 rpm progressively increasing WR(work rate) exercise of 5 to 15 W /min to maximum tolerance, 2 minutes of recovery. Pulse oximetry (SpO2), heart rate (HR), 12-lead ECG, and cuff blood pressure were monitored and recorded breath-by-breath analysis is important breath-by-breath analysis can provide the best measures of the metabolic response to exercise(A non-rebreathing valve is connected to a mouthpiece to prevent mixing of inspired and expired air) Patients 32 SSc patients had been diagnosed with SSc according to the criteria of the American College of Rheumatology (ACR) all patients had chest X-rays and/or CT. All patients had echocardiography with estimation of pulmonary artery pressure (PAP). Patients with estimated systolic PAP 35 mmHg were excluded. Other measurements 6-minute walk test. Pulmonary function testing VO2 VO2 = (SV ×HR) ×(Cao2 - Cvo2) VO2 :oxygen uptake SV : stroke volume, HR : heart rate Cao2 :arterial oxygen content Cvo2:mixed venous oxygen content equivalent (MET) resting oxygen uptake in a sitting position peakVo2 peakVo2 = (SVmax × HRmax) ×(Cao2max -Cvo2max) This reflects the maximal ability of a person to take in, transport and use oxygen. It defines that person’s functional aerobic capacity. In healthy people, a VO2 plateau occurs at near maximal