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The Role of Exercise Testing in the Modern Management of Pulmonary Arterial Hypertension

Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Agamemnon Street, Clydebank G81 4DY, UK
Author to whom correspondence should be addressed.
Diseases 2014, 2(2), 120-147;
Received: 12 April 2014 / Revised: 28 April 2014 / Accepted: 30 April 2014 / Published: 28 May 2014
(This article belongs to the Special Issue Pulmonary Arterial Hypertension (PAH))
A culture of exercise testing is firmly embedded in the management of pulmonary arterial hypertension (PAH) but its clinical relevance and utility have recently been under some debate. The six minute walk test (6MWT) has been used as a primary outcome measure to enable the licensing of many of the medications used for this condition. Recent reviews have questioned the validity of this test as a surrogate of clinical outcomes. At the same time, other questions are emerging where exercise testing may be the solution. With the rise in understanding of genetic markers of idiopathic PAH (IPAH), the screening of an otherwise healthy population for incipient pulmonary hypertension (PH) will be required. The proliferation in treatment choices and identification of populations with PH where PAH treatment is not indicated, such as left heart and lung disease, requires more definitive differentiation from patients with PAH. There is a continuing question about the existence and clinical relevance of exercise induced PAH as a cause of unexplained dyspnoea and fatigue and as a latent phase of resting PH. This review presents a summary and critical analysis of the current role of exercise testing in PAH and speculates on future trends. View Full-Text
Keywords: pulmonary arterial hypertension; exercise testing; activity monitoring pulmonary arterial hypertension; exercise testing; activity monitoring
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Johnson, M.K.; Thomson, S. The Role of Exercise Testing in the Modern Management of Pulmonary Arterial Hypertension. Diseases 2014, 2, 120-147.

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