To assess exertional breathlessness you must exert the breathless

摘要

Pulmonary arterial hypertension (PAH) and chronic thrombo-embolic pulmonary hypertension (CTEPH) are rare conditions associated with a poor prognosis, for which treatments are expensive and, at best, only moderately efficacious. Until the very latest stages of disease progression, symptoms occuralmost exclusively with physical exertion, most probably reflecting insufficient oxygen delivery to peripheral muscles caused through limitations of right ventricular (RV) reserve relative to heightened pulmonary vascular afterload.1 Despite this, assessments are most frequently performed at rest. In this issue of the journal, Blumberg and colleagues2 remind us that resting measures may be an inadequate surrogate of the pathophysi-ology of pulmonary hypertension when assessed during exercise.