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    Pulmonary hypERtension and measurement of exerciSe caPacIty REmotely: evaluation of the 1-minute sit to stand test (PERSPIRE): a cohort study

    Keen, Carol ORCID logoORCID: https://orcid.org/0000-0001-7803-1235, Smith, Ian, Hashmi-Greenwood, Molly, Sage, Karen ORCID logoORCID: https://orcid.org/0000-0002-7365-5177 and Kiely, David G (2023) Pulmonary hypERtension and measurement of exerciSe caPacIty REmotely: evaluation of the 1-minute sit to stand test (PERSPIRE): a cohort study. ERJ Open Research, 9 (1). 00295-00295. ISSN 2312-0541

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    Background: Multi-parameter risk assessment is recommended to aid treatment decisions in patients with pulmonary arterial hypertension. The 1-minute sit-to-stand test has been validated for use in other respiratory illnesses. The aim of this study was to evaluate its safety in the hospital setting and potential utility in remote assessment in patients with pulmonary hypertension. Methods: In a prospective cohort study design patients performed the 1-minute sit-to-stand and Incremental Shuttle Walk tests on the same day. The primary aim of the study was to assess safety signals and correlations with other metrics used in risk assessment. Results: Sixty patients with pulmonary arterial hypertension and 15 with chronic thromboembolic pulmonary hypertension were enrolled. No adverse events were recorded. Post-test change in physiological parameters was lower for the 1-minute sit-to-stand than for the Incremental Shuttle Walk test in heart rate (+9.4(8.0)bpm versus +38.3(25.9)bpm (p<0.001)), oxygen saturation (−3.8(4.0)% versus −8.9(7.3)%, (p<0.01)) and systolic blood pressure (+10.1(10.5)mmHg versus +17.7(19)mmHg, p<0.001). There were significant correlations between the 1-minute-sit-to-stand and Incremental Shuttle Walking test (r= 0.702, p< 0.01), WHO FC (−0.449, p<0.01), emPHAsis-10 (−0.436, p<0.001) and NT-proBNP (−0.270, p=0.022). Ninety-seven percent of patients were willing to perform the test at home. Conclusion: This study has demonstrated the safety, sub-maximal characteristics of the 1-minute sit-to-stand test in pulmonary arterial hypertension chronic thromboembolic pulmonary hypertension in the hospital setting, its positive correlation with the Incremental Shuttle Walk test and potential role in remote risk assessment. Further evaluation of this exercise test is now warranted.

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