Invasive Cardiopulmonary Exercise Testing in Chronic Thromboembolic Pulmonary Disease; Obesity and the VE/VCO2 Relationship

2024

Invasive Exercise Testing in Patients with Chronic Thromboembolic Disease and Obesity

Sample size: 60 publication 10 minutes Evidence: moderate

Author Information

Author(s): Oliveros Estefania, Mauri Madeline, Pietrowicz Rylie, Sadek Ahmed, Lakhter Vladimir, Bashir Riyaz, Auger William R., Vaidya Anjali, Forfia Paul R., Giallauria Francesco

Primary Institution: Temple University Hospital

Hypothesis

Does obesity affect the VE/VCO2 relationship in patients with chronic thromboembolic pulmonary disease?

Conclusion

Obesity significantly reduces the VE/VCO2 slope, which may mask important physiological evidence of pulmonary vascular obstruction in patients with chronic thromboembolic disease.

Supporting Evidence

A higher VE/VCO2 slope was observed in CTEPH compared to CTEPD (41.9 vs. 36.8).
Obesity was associated with a significant reduction in the VE/VCO2 slope.
For every 1 point increase in BMI, the VE/VCO2 slope decreased by 0.6 in CTEPD and 0.35 in CTEPH.
The study included 60 patients with a mean BMI of 31.8.
CTEPH patients had higher resting mPAP and PVR compared to CTEPD patients.
Statistical analysis showed significant differences in gas exchange parameters between groups.
The VE/VCO2 slope had a modest ability to discriminate between CTEPH and CTEPD.
Obesity can mask the physiological evidence of pulmonary vascular obstruction.

Takeaway

This study found that being overweight can make it harder to see how well your lungs are working during exercise, especially for people with certain lung diseases.