Exercise-Induced Pulmonary Hypertension Robert Naeije, MD, PhD, Rajeev Saggar, MD, PhD, David Badesch, MD, PhD, Sanjay Rajagopalan, MD, PhD, Luna Gargani, MD, PhD, Franz Rischard, MD, PhD, Francesco Ferrara, MD, PhD, Alberto M. Marra, MD, Michele D’ Alto, MD, PhD, Todd M. Bull, MD, PhD, Rajan Saggar, MD, PhD, Ekkehard Grünig, MD, Eduardo Bossone, MD, PhD, FCCP  CHEST  Volume 154, Issue 1, Pages 10-15 (July 2018) DOI: 10.1016/j.chest.2018.01.022 Copyright © 2018 American College of Chest Physicians Terms and Conditions

Figure 1 Mean pulmonary artery pressure (mPAP) as a function of cardiac output (CO) in three subjects (arrows): subjects 1 and 2 are normal, even though subject 2 has an exercise mPAP > 30 mm Hg and subject 3 has an abnormal response suggesting exercise-induced pulmonary hypertension. A prediction band defining limits of normal (shaded area) was calculated by quadratic fitting of pooled pressure-flow data from 137 healthy volunteers reported in Lewis et al.9 TPR = total pulmonary resistance; WU = Wood units. Reprinted with permission from Lewis GD, Bossone E, Naeije R, et al. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation. 2013;128:1470-1479. http://circ.ahajournals.org/. CHEST 2018 154, 10-15DOI: (10.1016/j.chest.2018.01.022) Copyright © 2018 American College of Chest Physicians Terms and Conditions

Figure 2 Kaplan-Meier curves of transplant-free survival of 72 patients with systemic sclerosis according to their hemodynamic classification. PHex = exercise-induced precapillary pulmonary hypertension; PHnone = patients without pulmonary hypertension at rest and without exercise-induced PH; PHrest = resting precapillary pulmonary hypertension. From Stamm et al.48 Reproduced with permission of the © ERS 2018: Eur Respir J. 2016;48(6):1658-1667; https://doi.org/10.1183/13993003.00990-2016. CHEST 2018 154, 10-15DOI: (10.1016/j.chest.2018.01.022) Copyright © 2018 American College of Chest Physicians Terms and Conditions