Oxygen kinetics during 6-minute walk tests in patients with cardiovascular and pulmonary disease

BMC Pulmonary Medicine

Martin Brutsche⁷  Michael Tamm⁶  Andrea Azzola³  Arno JR van Gestel⁴  Jan Wiegand²  Florent Baty⁷  Sophie Condrau¹  Lukas Kern⁵ 

[1] Division of Internal Medicine, Regional Hospital Biel, Biel, Switzerland;Division of Critical Care Medicine, University Hospital Bern, Bern, Switzerland;Division of Pulmonary Medicine, Regional Hospital Lugano, Lugano, Switzerland;Department of Health, Zurich University of Applied Sciences, Winterthur, Switzerland;Division of Pulmonary Medicine, Cantonal Hospital Zug, Zug, Switzerland;Division of Pulmonary Medicine, University Hospital Basel, Basel, Switzerland;Division of Pulmonary Medicine, Hospital St. Gallen, CH-9002 St. Gallen, Switzerland

关键词: Cardiopulmonary exercise testing;    Submaximal exercise;    Mobile cardiopulmonary monitoring;    6-minute walk test;    Oxygen uptake kinetics;   

Others  :  1091661
DOI  :  10.1186/1471-2466-14-167

 received in 2013-08-05, accepted in 2014-10-20,  发布年份 2014

【 摘 要 】

Background

The 6-Minute Walk Test (6MWT) is representative of daily-life activities and reflects the functional capacity of patients. The change of oxygen uptake (VO₂) in the initial phase of low-intensity exercise (VO₂ kinetics) can be used to assess submaximal exercise performance of patients.

The objective of the following study was to analyse VO₂ kinetics in patients with different pulmonary and cardiovascular diseases. In addition, we investigated the extent to which VO₂ kinetics at the onset of the 6MWT were associated with exercise capacity, morbidity and mortality.

Methods

VO₂ kinetics of 204 patients and 16 healthy controls were obtained using mobile telemetric cardiopulmonary monitoring during a 6MWT. A new mean response time (MRT) index (wMRT) was developed to quantify VO₂ kinetics by correcting MRT for work rate. The differences in wMRT between disease categories as well as the association between wMRT and patients’ exercise capacity and outcome - time to hospitalization/death- were tested.

Results

The assessment of a robust wMRT was feasible in 86% (244/284) patients. wMRT was increased in patients compared to healthy controls (p <0.001). wMRT was largest in patients with pulmonary arterial hypertension (PAH). There were significant associations between wMRT and exercise capacity in all patients. High wMRT was found to be associated with a high rate of death and re-hospitalization in patients with CHF (p = 0.024). In patients with pulmonary diseases and pulmonary hypertension wMRT was not associated with outcome (p = 0.952).

Conclusions

Submaximal exercise performance of patients is reduced. O₂ kinetics at the onset of exercise are associated with exercise capacity in all patients. wMRT was found to be an important prognostic factor in patients with congestive heart failure (CHF), but not with pulmonary diseases.

【 授权许可】

   
2014 Kern et al.; licensee BioMed Central Ltd.

【 图 表 】

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