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Ultrasound in Regional Anesthesia

2009; BMJ; Volume: 34; Issue: 6 Linguagem: Inglês

10.1097/aap.0b013e3181c0f025

1532-8651

Brian D. Sites, Joseph M. Neal, Vincent Chan,

Anesthesia and Pain Management

Exercise tolerance in pulmonary arterial hypertension (PAH) is most commonly assessed by the 6-min walk test (6MWT). Whether endurance exercise tests are more responsive than the 6MWT remain unknown. Twenty stable PAH patients (mean age: 53[15]; mean pulmonary arterial pressure: 44[16]) already on PAH monotherapy completed the 6MWT, the endurance shuttle walk test (ESWT) and the cycle endurance test (CET) before and after the addition of sildenafil citrate 20 mg tid or placebo for 28 days in a randomized double-blind crossover setting. Pre/post-placebo tests were used to assess repeatability of each exercise test, whereas pre/post-sildenafil citrate tests were used to assess their responsiveness. Sildenafil citrate led to placebo-corrected changes in exercise capacity of +18(25)meters (p=0.02), +58(235)seconds (p=0.58), and +29(77)seconds (p=0.09), for the 6MWT, the ESWT and the CET, respectively. The 6MWT was associated a lower coefficient of variation between repeated measures (3 vs. 18 vs. 13%), resulting in a higher standardized response mean compared to endurance tests (0.72, 0.25 and 0.38 for the 6MWT, the ESWT and CET, respectively). The 6MWT had the best ability to capture changes in exercise capacity when sildenafil citrate was combined to patients9 baseline monotherapy, supporting its use as an outcome measure in PAH.