A novel expression of exercise induced pulmonary hypertension in human immunodeficiency virus patients: A pilot study

Rami Doukky, Won Y. Lee, Mahindhar Ravilla, Omar B. Lateef, Victor Pelaez, Audrey French, Rajive Tandon

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Patients with the human immunodeficiency virus (HIV) are at risk for multiple pulmonary complications including pulmonary hypertension. Exercise induced pulmonary hypertension (EIPH) has been previously described in patients with scleroderma, sickle cell disease and chronic obstructive pulmonary disease, yet has not been associated with the HIV population. Methods: A prospective case-control study design was implemented. Four HIV patients with unexplained dyspnea and four healthy controls underwent symptom-limited stationary bicycle exercise. Transthoracic Doppler Echocardiography was used to measure tricuspid regurgitation velocity which was used to calculate the right ventricular to right atrial pressure (RV-RA) gradient at rest and at peak exercise using the simplified Bernoulli's equation. Change in RV-RA gradient between rest and peak exercise was calculated and considered to represent change in pulmonary arterial systolic pressure. Results: The mean age was 41.25 years (±8.7) for patients and 33.5 years (±6.0) for controls. The mean CD4 count of patients was 191.5 cells/μL (±136.2). Patients had a significantly higher increase in RV-RA gradient as compared to controls (180.2% vs. 27.5%, p = 0.03). Discussion: This pilot study suggests that it is feasible to use recumbent bicycle and transthoracic Doppler echocardiography for the evaluation of EIPH among HIV patients with dyspnea of unknown etiology. The study is too small to draw any broad conclusion. Further evaluation of this concept with a larger study is warranted.

Original languageEnglish (US)
Pages (from-to)44-49
Number of pages6
JournalOpen Cardiovascular Medicine Journal
Volume6
Issue number1
DOIs
StatePublished - May 14 2012

Keywords

  • Exercises induced pulmonary hypertension
  • Human immunodeficiency virus (HIV)
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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