Wu YW, et al. – The current study was interested in exploring the diagnostic and prognostic implications of exercise treadmill and rest first–pass radionuclide angiography (FP–RNA) in patients With pulmonary hypertension (PH). The results of this study showed that exercise treadmill and rest FP–RNA provided diagnostic value and had prognostic implications in patients with PH.

Methods

• For this purpose, left and right ventricular ejection fraction (LVEF/RVEF) and pulmonary mean transit time (PMTT) at rest and quickly after exercise treadmill test were measured by FP-RNA in 77 consecutive patients with clinical presentations suggestive of PH (aged 46 ± 15 years, 33 men), mostly with symptoms of unexplained progressive dyspnea.
• These parameters, along with other clinical variables, were associated with right-sided heart catheterization data and clinical results.

Results

• Researchers reported that 50 patients (64.9%) were diagnosed as having definite PH.
• Other than higher N-terminal pro–B-type natriuretic peptide levels, right atrial pressure, and pulmonary vascular resistance, PH patients had significantly longer PMTT, lower LVEF after exercise and rest, and lower poststress RVEF (all P < 0.05), compared with non-PH subjects.
• PH patients displayed stress-induced right ventricular dysfunction and stationary poststress PMTT.
• Findings revealed that poststress PMTT and echocardiography had comparable diagnostic utility (area under the curve, 0.80 vs 0.84, respectively).
• It was noted that 18 patients died during a median follow-up period of 380 days.
• The study results showed that failure of exercise treadmill test, lower peak heart rate response, and stress/rest LVEF ratio of less than 90% using exercise treadmill FP-RNA were independent predictors of mortality in PH patients.