IntroductionPulmonary complications in systemic sclerosis (SSc) significantly increase morbidity and mortality. Our aim was to determine the factors limiting exercise capacity in SSc patients with and without interstitial lung disease (ILD), and to identify and quantify abnormalities during exercise that might assist in clinical assessment of this complication. MethodsFifteen patients with SSc and ILD (SSc-ILD) were compared with 10 patients with SSc without ILD and 9 age- and sex-matched normal volunteers. Subjects performed symptom-limited incremental treadmill exercise with online measurement of respiratory gas exchange, arterial blood gas sampling and measurement of neurohormones in venous blood. ResultsPatients with SSc-ILD had lower exercise capacity than SSc patients without ILD or normal subjects (peak oxygen consumption (PV?O-2) (17.1 [4.2] vs. 22.0 [4.7] and 23.0 [5.4] ml kg(-1) min(-1), respectively, mean [SD], p < 0.01 ANOVA), but PV?O-2 did not correlate with static pulmonary function measurements. Ventilatory equivalent for CO2 (V?E/V?CO2; nadir) was higher in SSc-ILD patients than the other two groups (36.6 [8.0] vs. 29.9 [4.4] and 30.0 [2.5], p < 0.005) as were peak exercise dead-space tidal volume ratio (0.44 [0.06] vs. 0.26 [0.09] and 0.26 [0.05], p < 0.001) and peak exercise alveolar-arterial difference (28.9 [16.9] vs. 18.8 [14.0] and 11.5 [6.9] mmHg, p < 0.05). Atrial natriuretic peptide was elevated in both SSc patient groups. ConclusionsSSc-ILD results in lower exercise capacity than SSc without ILD, and abnormalities of gas exchange are seen. The possible use of cardiopulmonary exercise testing to identify disease and quantify impairment in SSc-ILD merits further study.
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Paris Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, FranceParis Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, France
Allanore, Yannick
Meune, Christophe
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Paris Descartes Univ, Hop Cochin, AP HP, Dept Cardiol, F-75014 Paris, FranceParis Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, France
Meune, Christophe
Kahana, Andre
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机构:Paris Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, France
机构:
Paris Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, FranceParis Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, France
Allanore, Yannick
Meune, Christophe
论文数: 0引用数: 0
h-index: 0
机构:
Paris Descartes Univ, Hop Cochin, AP HP, Dept Cardiol, F-75014 Paris, FranceParis Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, France
Meune, Christophe
Kahana, Andre
论文数: 0引用数: 0
h-index: 0
机构:Paris Descartes Univ, Hop Cochin, AP HP, Serv Rhumatol,Dept Rheumatol A, F-75014 Paris, France