{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:01:23Z","timestamp":1788847283491,"version":"build-2803163510"},"reference-count":31,"publisher":"BMJ","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"accepted":{"date-parts":[[2011,7,29]]},"published-print":{"date-parts":[[2011,12,15]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Impaired right ventricular (RV) myocardial blood flow (MBF) has been associated with RV dysfunction and fatal RV failure in idiopathic pulmonary hypertension during stress. MBF and O<jats:sub>2<\/jats:sub> extraction from myocardial capillaries (O<jats:sub>2<\/jats:sub> extraction fraction (OEF)) influence myocardial O<jats:sub>2<\/jats:sub> supply.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine how the baseline RV OEF affects the amount of MBF increase induced by supine exercise, the authors hypothesise that higher baseline OEF (H-OEF) results in limited O<jats:sub>2<\/jats:sub> extraction during exercise and that MBF must therefore be increased to obtain sufficient O<jats:sub>2<\/jats:sub>.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In 18 patients with idiopathic pulmonary hypertension, baseline OEF, resting MBF and exercise-induced MBF at 40% of maximal cardiopulmonary exercise testing load were measured using positron emission tomography and [<jats:sup>15<\/jats:sup>O]O<jats:sub>2<\/jats:sub>, [<jats:sup>15<\/jats:sup>O]H<jats:sub>2<\/jats:sub>O and [<jats:sup>15<\/jats:sup>O]CO.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>For the whole population, exercise increased RV MBF from 0.68\u00b10.16 to 1.13\u00b10.38\u2005ml\/min\/g (p&lt;0.0001). The MBF exercise-to-rest ratio (reserve) was 1.7\u00b10.7. The median baseline OEF was 0.73 at which the patient population was split into H-OEF and lower baseline OEF (L-OEF). Baseline MBF values (0.61\u00b10.11 and 0.74\u00b10.17\u2005ml\/min\/g, respectively) were similar, and exercise induced a significant MBF increase in both groups (p=0.0001). However, exercise-induced increase in MBF was significantly less in the H-OEF group than in the L-OEF group (0.97\u00b10.30 and 1.30\u00b10.39\u2005ml\/min\/g, respectively, p&lt;0.05). Moreover, H-OEF patients had lower baseline stroke volume and cardiac output than the L-OEF group (52\u00b119\u2005ml and 4.0\u00b11.1\u2005l\/min vs 78\u00b118\u2005ml and 5.5\u00b10.9\u2005l\/min, respectively, both p&lt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>H-OEF patients were hemodynamically poorer and showed a lower exercise-induced MBF increase compared to L-OEF patients, suggesting exercise-induced O<jats:sub>2<\/jats:sub> supply limitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2011-300237","type":"journal-article","created":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T06:56:20Z","timestamp":1314860180000},"page":"2069-2074","source":"Crossref","is-referenced-by-count":12,"title":["Supine-exercise-induced oxygen supply to the right myocardium is attenuated in patients with severe idiopathic pulmonary arterial 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