Pulmonary vascular and right ventricular burden during exercise in interstitial lung disease.

Abstract Background Pulmonary hypertension (PH) adversely impact patient´s exercise capacity in interstitial lung disease (ILD). Pulmonary vascular and right ventricular (RV) dysfunction impact, however, have traditionally been thought to be mild, and clinically relevant principally in advanced lung disease states. We sought to evaluate the relative contributions of pulmonary mechanics, pulmonary vascular and RV function to the ILD exercise limit. Methods 49 ILD patients that underwent resting right heart catheterization followed by invasive exercise testing were evaluated. Patients with PH at rest (ILD+rPH) and with PH diagnosed exclusively during exercise (ILD+ePH) were contrasted to ILD patients without PH (ILD non-PH). Results Peak oxygen consumption (VO2) was reduced in ILD+rPH (61±10 %predicted) and ILD+ePH (67±13 %predicted) compared to ILD non-PH (81±16 %predicted; p Conclusions ILD with resting and exercise PH is associated with increased exercise RV work, reduced pulmonary vascular reserve and reduced peak VO2. The findings highlight the role of pulmonary vascular and RV burden to ILD exercise limit.