Determinants of exercise capacity in cystic fibrosis patients with mild-to-moderate lung disease

BMC Pulmonary Medicine

Benoit Wallaert²  Alain Duhamel¹  Carole Langlois¹  Catherine Tardif³  Anne Prévotat²  Jean Pastré² 

[1] Unité de Biostatistiques, CHRU Lille, France;Université Lille 2 et Clinique des Maladies Respiratoires, CRCM Hôpital Calmette, CHRU Lille, France;Service de Physiologie Respiratoire, CHRU Rouen, France

关键词: Exercise;    Pulmonary function;    Cardiopulmonary exercise testing;    Cystic fibrosis;   

Others  :  862977
DOI  :  10.1186/1471-2466-14-74

 received in 2013-06-28, accepted in 2014-04-23,  发布年份 2014

【 摘 要 】

Background

Adult patients with cystic fibrosis (CF) frequently have reduced exercise tolerance, which is multifactorial but mainly due to bronchial obstruction. The aim of this retrospective analysis was to determine the mechanisms responsible for exercise intolerance in patients with mild-to-moderate or severe disease.

Methods

Cardiopulmonary exercise testing with blood gas analysis at peak exercise was performed in 102 patients aged 28 ± 11 years: 48 patients had severe lung disease (FEV₁ < 50%, group 1) and 54 had mild-to-moderate lung disease (FEV₁ ≥ 50%, group 2). VO₂ peak was measured and correlated with clinical, biological, and functional parameters.

Results

VO₂ peak for all patients was 25 ± 9 mL/kg/min (65 ± 21% of the predicted value) and was < 84% of predicted in 82% of patients (100% of group 1, 65% of group 2). VO₂ peak was correlated with body mass index, C-reactive protein, FEV₁, FVC, RV, DLCO, V_E/VCO₂ peak, V_D/V_T, PaO₂, PaCO₂, P(A-a)O₂, and breathing reserve. In multivariate analysis, FEV₁ and overall hyperventilation during exercise were independent determinants of exercise capacity (R² = 0.67). FEV₁ was the major significant predictor of VO₂ peak impairment in group 1, accounting for 31% of VO₂ peak alteration, whereas excessive overall hyperventilation (reduced or absent breathing reserve and V_E/VCO₂) accounted for 41% of VO₂ alteration in group 2.

Conclusion

Exercise limitation in adult patients with CF is largely dependent on FEV₁ in patients with severe lung disease and on the magnitude of the ventilatory response to exercise in patients with mild-to-moderate lung disease.

【 授权许可】

   
2014 Pastré et al.; licensee BioMed Central Ltd.

【 图 表 】

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