Comparison of activities of daily living in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH)

Introduction: Compared to IPAH, patients with CTEPH have greater abnormalities in gas exchange and ventilatory responses during maximum exercise test. Thus, it is possible that these patients have a higher limitation to perform activities of daily living (ADL). Objective: To compare energy expenditure and pathophysiological responses during the simulation of activities of daily living in patients with CTEPH and IPAH. Methods: Cross-sectional study including 9 patients with CTEPH (49±11.8yrs, 66.7% male, 55.6% NYHA FC II and III) and 12 with IPAH (37.4±9.4yrs, 38.5% male, 46.2% NYHA FC II and III). All patients underwent simulation of 10 ADLs with use of Oxycom Mobile device. The oxygen consumption (VO 2 ) during ADL was analyzed in absolute value and as a percentage of Peak VO 2 in incremental exercise test. Results: Patients with CTEPH presented higher VO 2 for walking with 2.5 kg in both hands for 5 minutes (100 ± 16.7% vs 83.2 ± 16.8%, p = 0.03) and walking with 5kg in one hand for another 5 minutes (105.9 ± 18.2% vs 89.8 ± 13.9%, p = 0.042). In both groups, many of ADLs were performed above the anaerobic threshold and very close to their peak aerobic capacity. There was a higher degree of dessaturation and increased VE/VCO 2 in patients with CTEPH. Conclusion: Patients with CTEPH have higher desaturation and excessive ventilatory responses while performing ADL, compared to patients with IPAH.