{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T14:33:05Z","timestamp":1785594785256,"version":"3.56.0"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["Grant-in-Aid for Scientific Research (21K08087)"],"award-info":[{"award-number":["Grant-in-Aid for Scientific Research (21K08087)"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Pulmonary hypertension (PH) is a common and morbid complication of left heart disease (LHD), comprising two subtypes: (1) isolated post-capillary pulmonary hypertension (Ipc-PH) and (2) combined post-capillary and pre-capillary pulmonary hypertension (Cpc-PH). Knowledge regarding the physiological characteristics that distinguish Cpc-PH, which has a worse prognosis, from Ipc-PH remains limited. Therefore, this study aimed to assess the utility of cardiopulmonary exercise testing (CPET) variables in detecting Cpc-PH.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and results<\/jats:title>\n<jats:p>Among 105 consecutive patients with LHD (age: 55 \u00b1 13 years; male\/female = 79\/26) who underwent right heart catheterization and CPET, 45 (43%) were classified as PH-LHD (mean pulmonary artery pressure &gt;20 mmHg). Ipc-PH (n = 24) was defined as pulmonary vascular resistance (PVR) \u2264 3 WU and Cpc-PH (n = 21) as PVR &gt; 3 WU. Patients with Cpc-PH had a significantly lower peak partial pressure of carbon dioxide (PETCO<jats:sub>2<\/jats:sub>) (Non-PH\/Ipc-PH\/Cpc-PH = 38.2 \u00b1 6.6 vs. 38.3 \u00b1 6.0 vs 33.0 \u00b1 4.4 mmHg, p = 0.006), higher VE vs. VCO<jats:sub>2<\/jats:sub> slope (Non-PH\/Ipc-PH\/Cpc-PH = 33.0 [28.3, 36.6] vs. 32.5 [28.1, 37.8] vs. 40.6 [33.6, 46.1], p = 0.007), and lower \u0394VO<jats:sub>2<\/jats:sub>\/\u0394WR (Non-PH\/Ipc-PH\/Cpc-PH = 8.5 \u00b1 1.4 vs. 8.0 \u00b1 1.7 vs. 6.8 \u00b1 2.0 mL\/min\/watt, p = 0.001) than those with Ipc-PH and non-PH. Using multivariable logistic regression analysis, CPET variables were found to be independent predictors of Cpc-PH (lower peak PETCO<jats:sub>2<\/jats:sub>: odds ratio, 0.728 [95% confidence interval {CI}: 0.616\u20130.840], p = 0.003 and lower \u0394VO<jats:sub>2<\/jats:sub>\/\u0394WR: odds ratio, 0.747 [95% CI: 0.575\u20130.872], p = 0.003).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>From our exploratory analysis, CPET variables, especially in the lower peak PETCO<jats:sub>2<\/jats:sub> and lower \u0394VO<jats:sub>2<\/jats:sub>\/\u0394WR, were associated with Cpc-PH in patients with left heart disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0286057","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T17:22:24Z","timestamp":1684776144000},"page":"e0286057","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Characteristics of cardiopulmonary exercise testing in patients with combined post- and pre-capillary pulmonary hypertension due to left heart 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