Responses to exercise in systemic sclerosis-associated interstitial lung disease

被引:0
作者
Donnelly, Ronan P. [1 ]
Smyth, Anita E. [2 ]
Mullan, Charles [3 ]
Riley, Marshall S. [3 ,4 ]
Nicholls, D. Paul [1 ]
机构
[1] Royal Victoria Hosp, Belfast, North Ireland
[2] Ulster Hosp, Dept Rheumatol, Dundonald, North Ireland
[3] City Hosp, Belfast, North Ireland
[4] City Hosp, Belfast BT9 7AB, North Ireland
关键词
exercise test; neurohumoral responses; pulmonary fibrosis; pulmonary gas exchange; scleroderma; BRAIN NATRIURETIC PEPTIDE; PULMONARY-ARTERY PRESSURE; GAS-EXCHANGE; PATHOPHYSIOLOGY; FAILURE; HYPERTENSION; DYSFUNCTION; LIMITATION; CAPACITY; INCREASE;
D O I
10.1111/cpf.12813
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
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.
引用
收藏
页码:253 / 262
页数:10
相关论文
共 41 条
  • [1] AGUSTI AG, 1988, EUR RESPIR J, V1, P510
  • [2] Systemic sclerosis and cardiac dysfunction: evolving concepts and diagnostic methodologies
    Allanore, Yannick
    Meune, Christophe
    Kahana, Andre
    [J]. CURRENT OPINION IN RHEUMATOLOGY, 2008, 20 (06) : 697 - 702
  • [3] Peak VO2 and VE/VCO2 slope in patients with heart failure:: A prognostic comparison
    Arena, R
    Myers, J
    Aslam, SS
    Varughese, EB
    Peberdy, MA
    [J]. AMERICAN HEART JOURNAL, 2004, 147 (02) : 354 - 360
  • [4] Bohr C., 1891, SKAND ARCH PHYSIOL, V2, P236, DOI DOI 10.1111/J.1748-1716.1891.TB00581.X
  • [5] Phenotyping Exercise Limitation in Systemic Sclerosis: The Use of Cardiopulmonary Exercise Testing
    Boutou, Afroditi K.
    Pitsiou, Georgia G.
    Siakka, Panagiota
    Dimitroulas, Theodoros
    Paspala, Asimina
    Sourla, Evdokia
    Chavouzis, Nikolaos
    Garyfallos, Alexandros
    Argyropoulou, Paraskevi
    Stanopoulos, Ioannis
    [J]. RESPIRATION, 2016, 91 (02) : 115 - 123
  • [6] OPTIMIZING THE EXERCISE PROTOCOL FOR CARDIOPULMONARY ASSESSMENT
    BUCHFUHRER, MJ
    HANSEN, JE
    ROBINSON, TE
    SUE, DY
    WASSERMAN, K
    WHIPP, BJ
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1983, 55 (05) : 1558 - 1564
  • [7] Cryptogenic fibrosing alveolitis and the fibrosing alveolitis of systemic sclerosis: Morphological differences on computed tomographic scans
    Chan, TYK
    Hansell, DM
    Rubens, MB
    duBois, RM
    Wells, AU
    [J]. THORAX, 1997, 52 (03) : 265 - 270
  • [8] Inappropriate exercise-induced increase in pulmonary artery pressure in patients with systemic sclerosis
    D'Alto, Michele
    Ghio, Stefano
    D'Andrea, Antonello
    Pazzano, Anna Sara
    Argiento, Paola
    Camporotondo, Rita
    Allocca, Francesca
    Scelsi, Laura
    Cuomo, Giovanna
    Caporali, Roberto
    Cavagna, Lorenzo
    Valentini, Gabriele
    Calabro, Raffaele
    [J]. HEART, 2011, 97 (02) : 112 - 117
  • [9] Neurohormonal Axis in Patients with Pulmonary Arterial Hypertension Friend or Foe?
    de Man, Frances S.
    Handoko, M. Louis
    Guignabert, Christophe
    Bogaard, Harm J.
    Vonk-Noordegraaf, Anton
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2013, 187 (01) : 14 - 19
  • [10] Reduced exercise capacity in systemic sclerosis patients without pulmonary involvement
    de Oliveira, N. C.
    Sabbag, L. M. dos Santos
    Ueno, L. M.
    de Souza, R. B. C.
    Borges, C. L.
    de Sa Pinto, A. L.
    Lima, F. R.
    [J]. SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, 2007, 36 (06) : 458 - 461