Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension

@article{Mainguy2012RepeatabilityAR,
  title={Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension},
  author={Vincent Mainguy and Simon Malenfant and Anne-Sophie Neyron and S{\'e}bastien Bonnet and François Maltais and Didier Saey and Steeve Provencher},
  journal={European Respiratory Journal},
  year={2012},
  volume={42},
  pages={425 - 434}
}
Exercise tolerance in pulmonary arterial hypertension (PAH) is most commonly assessed by the 6-min walk test (6MWT). Whether endurance exercise tests are more responsive than the 6MWT remains unknown. 20 stable PAH patients (mean±sd age 53±15 years and mean pulmonary arterial pressure 44±16 mmHg) already on PAH monotherapy completed the 6MWT, the endurance shuttle walk test (ESWT) and the cycle endurance test (CET) before and after the addition of sildenafil citrate 20 mg three times daily or… 
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TLDR
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References

SHOWING 1-10 OF 31 REFERENCES
Effects of exercise training in patients with idiopathic pulmonary arterial hypertension
TLDR
Exercise training in patients with idiopathic pulmonary arterial hypertension improves exercise endurance and quadriceps muscle function, which is also reflected by structural changes of the Quadriceps.
Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension. Comparison with cardiopulmonary exercise testing.
TLDR
It is suggested that the six-minute walk test, a submaximal exercise test, reflects exercise capacity determined by maximal cardiopulmonary exercise testing in patients with PPH, and it is the distance walked in 6 min that has a strong, independent association with mortality.
The minimal important difference in the 6-minute walk test for patients with pulmonary arterial hypertension.
TLDR
The estimated consensus MID in the 6MWT for PAH is approximately 33 m, which has important implications for assessing treatment responses from clinical trials and metaanalyses of specific PAH therapy, and sample size calculations for future study design.
Effects of a Rehabilitation Program on Skeletal Muscle Function in Idiopathic Pulmonary Arterial Hypertension
TLDR
Peripheral muscle characteristic improvements may contribute to the clinical benefit observed following a rehabilitation program in patients with idiopathic pulmonary arterial hypertension.
Determinants of the exercise endurance capacity in patients with chronic obstructive pulmonary disease. The power-duration relationship.
TLDR
The reductions of both parameters of the hyperbolic W-t relationship (theta(F) and W') in patients with COPD were due to the ventilatory constraints and their sensory consequences: this parameter consistently occurred closer to peak work rate in patients than the healthy control subjects.
The effects of oxitropium bromide on exercise performance in patients with stable chronic obstructive pulmonary disease. A comparison of three different exercise tests.
TLDR
The endurance test was the most sensitive in detecting the effects of inhaled anticholinergic agents on exercise performance in patients with stable COPD, and it is concluded that an endurance procedure may be performed to detect clinical changes.
Six-minute walking versus shuttle walking: responsiveness to bronchodilation in chronic obstructive pulmonary disease
TLDR
The endurance shuttle walk is more responsive than the 6MWT for detecting changes in exercise performance following bronchodilator-induced changes inercise performance with a randomized, double-blind, placebo-controlled, crossover trial.
Factors Determining Constant Work Rate Exercise Tolerance in COPD and their Role in Dictating the Minimal Clinically Important Difference in Response to Interventions
TLDR
Arguments are presented that a pre-intervention constant work rate duration of 4–7 minutes is desirable, and the recommended strategy to achieve this target duration is to choose a work rate equal to 85% of peak work rate achieved in a constant work rates test.
Assessment of Survival in Patients With Primary Pulmonary Hypertension: Importance of Cardiopulmonary Exercise Testing
TLDR
Peak &OV0312;o2 and peak SBP are independent and strong predictors of survival in PPH patients, and Hemodynamic parameters, although also accurate predictors, provide no independent prognostic information.
...
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3
4
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