Physiologic Markers of Exercise as a Potential Screening Tool for the Detection of Pulmonary Hypertension: “α” Few Steps Forward

摘要

The normal pulmonary circulation is a high-flow and low-pressure circuit, capable of handling exercise-associated increases in cardiac output and transmural pressures through distension and recruitment of pulmonary capillaries, which in turn leads to decreased pulmonary vascular resistance. The distensible properties of the pulmonary capillaries represent an important advantage for the right ventricle (RV) during exercise, allowing it to operate with maximal efficiency and at lower energy consumption. If the field of pulmonary hypertension (PH) could identify when this vascular response to exercise becomes abnormal, we may have an advantage for tracking those subclinical, at-risk patients before the development of overt resting?PH. The epidemiologic impact of early identification is sizeable when considering that severe delays in PH diagnosis and referral remain a problem in?modern clinical practice and for population-derived registries.