Pulmonary vascular disease & thromboembolismCohort study
Exercise Haemodynamics in Pulmonary Hypertension – a Prospective Pressure–Volume Loop Study on Right Ventricular Adaptation and Prognosis
- Prospective cohort study
- pressure-volume loop study
Authors' conclusion
Pulmonary hypertension can present with two RV patterns under stress: homeometric with increased contractile reserve and heterometric with poorer outcome.
Study context
- Population
- Patients with pulmonary hypertension undergoing exercise pressure-volume catheterization46 pulmonary hypertension (PH), 19 controls
- Participants
- 18 / 28 / 19
- Exposure
- Homeometric vs heterometric right ventricular (RV) adaptation to exercise in PH
- Homeometricn = 18reference
- Heterometricn = 28
- Disease controlsn = 19
Main finding
As reported in the abstract
Clinical worsening and all-cause mortality by RV adaptation
Heterometric vs HomeometricHazard ratio (95% CI)P value
clinical worsening; log-rank p = 0.0006
6.52(2.16–19.63)
P = 0.001all-cause mortality; log-rank p = 0.0246
6.96(0.87–55.66)
P = 0.067Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Differentiators of homeometric/heterometric adaptation (multivariable logistic regression) — ΔsPAP vs Homeometric | 0.93 (0.87–0.99) | P = 0.019 | |
| Differentiators of homeometric/heterometric adaptation (multivariable logistic regression) — Peak exercise cardiac index vs Homeometric | 0.42 (0.18–0.97) | P = 0.042 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Homeometric | Heterometric | Disease controls | Estimate | P value |
|---|---|---|---|---|---|
| mPAP/CO slope | 8.8 (range 6.5–13.1) mmHg·min/L | 8.6 (range 4.8–18.8) mmHg·min/L | 2.1 (range 1.1–4.0) mmHg/L |
mPAP/CO slope
- Similar in homeometric and heterometric; lower in disease controls
Original publication
Exercise Haemodynamics in Pulmonary Hypertension – a Prospective Pressure–Volume Loop Study on Right Ventricular Adaptation and Prognosis. Eur J Heart Fail. Published 7 August 2025. doi:10.1002/ejhf.3802
Summarised from the published abstract; every number is checked against it