Pulmonary hypertension is associated with impaired exercise performance inpatients with systemic sclerosis

Objective: The aim of this study was to evaluate the exercise tolerance by expired gas analysis during stress test in patients with Systemic Sclerosis (SSc). Methods: Eighteen women (mean age 48.56+/-12.48 years) affected by SSc were studied. A complete echocardiographic examination including pulmonary arte ry systolic pressure estimation, pulmonary function tests, diffusion lung c apacity for carbon monoxide (DLco), and exercise test were performed. Durin g exercise, breath-by-breath expired gas analysis was performed. Results: Seven patients (39%) had baseline pulmonary systolic hypertension (group A) and 11 patients (61%) did not (group B). Six patients had reduced DLco values. Both maximal oxygen consumption (VO2max) and anaerobic thresh old (VO2AT) values were markedly decreased compared to the predicted values . Seven of 18 patients were unable to complete a maximal exercise (5 of who m affected by pulmonary systolic hypertension). Group A patients showed red uced VO2max, VO2AT, and O-2 pulse compared with patients with group B patie nts (p = 0.003, 0.017, and 0.013, respectively); VO2max, VO2AT and O-2 puls e were significantly correlated to baseline pulmonary artery systolic press ure. Conclusions: An exercise intolerance in patients affected by SSc is present . Impairment of exercise performance is associated with pulmonary hypertens ion.