ウエノ　アツコ   UENO Atsuko   上野　敦子    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
言語種別	日本語
発表タイトル	Relationship between Pulmonary Diffusing Capacity and Cardiopulmonary Exercise Test Findings in Patients with Heart Failure
会議名	第81回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎宮崎碧, 上野敦子, 鈴木豪, 萩原誠久
発表年月日	2017/03/18
開催地 （都市, 国名）	金沢市
学会抄録	第81回日本循環器学会学術集会　プログラム集 289
概要	Objectives To determine the relationship between lung diffusion impairment and the findings of cardiopulmonary exercise testing (CPX) and its clinical significance for patients with heart failure. Methods We studied 27 clinically stable patients with heart failure who underwent CPX between January 2013 and June 2016. All patients were assessed by CPX, echocardiography, right heart catheterization and pulmonary function tests within two weeks. We analyzed the relationship between pulmonary diffusing capacity for carbon monoxide (DLCO) and values derived from CPX, Swan‒Ganz catheterization, and echocardiography was examined. Results Majority of the patients had reduced left ventricular contraction (mean EF34±11%). Mean percent diffusing capacity of oxygen (%DLCO) was 65±18%. Nineteen patients showed %DLCO<70%. However, SpO2 dropped to within 2% in 21 patients from rest to peak exercise in CPX (mean SpO2 at rest 98±1%). Cardiac index (CI) was maintained properly as mean CI 2.63±0.70 L/min/m2. %DLCO showed no significant difference between patients with CI≥2.2 L/min/m2 and those with CI<2.2 L/min/m2 (%DLCO 69±18% vs 58±16%). There was a significant correlation between PETCO2 at rest or RCP and %DLCO (r=0.54, p<0.01 at rest; r=0.81, p<0.01 at RCP), peak VO2 (r=0.57, p<0.01), and VE vs VCO2 slope (r= ‒0.69, p<0.01). Conclusion The extent of gas‒exchange decrease in CPX seems to reflect pulmonary diffusion impairment more effectively than measurements in other examinations.