Article révisé par les pairs
Résumé : Sex and age affect the pulmonary circulation.Whether there may be racial differences in pulmonary vascular function is unknown. Thirty white European Caucasian subjects (15 women) and age and body-size matched 30 black Sub-Saharan African subjects (15 women) underwent a cardio-pulmonary exercise test and exercise stress echocardiography with measurements of pulmonary artery pressure (PAP) and cardiac output (CO). A pulmonary vascular distensibility coefficient α was mathematically determined from the natural curvilinearity of multipoint mean PAP (mPAP)–CO plots. Maximum oxygen uptake (VO2max) and workload were higher in the whites, while maximum respiratory exchange ratio and ventilatory equivalents for CO2 were the same. Pulmonary hemodynamics were not different at rest. Exercise was associated with a higher maximum total pulmonary vascular resistance (TPVR), steeper mPAP-CO relationships and lower α coefficients in the blacks. These differences were entirely driven by higher slopes of mPAP-CO relationships (2.5 ± 0.7 vs 1.4 ± 0.7 mmHg/L/min, P < 0.001) and lower α coefficients (0.85 ± 0.33 vs 1.35 ± 0.51 %/mmHg, P < 0.01) in black men compared to white men. There were no differences in any of the hemodynamic variables between black and white women. In men only, the slopes of mPAP-CO relationships were inversely correlated to VO2max (P<0.01). Thus the pulmonary circulation is intrinsically less distensible in black sub-Saharan African men as compared to white Caucasian Europeans men, and this is associated with a lower exercise capacity. This study did not identify racial differences in pulmonary vascular function in women.

Documents en relation

DI-fusion