Mechanisms of exercise limitation in patients with chronic hypersensitivity pneumonitis
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Citações na Scopus
13
Tipo de produção
article
Data de publicação
2018
Título da Revista
ISSN da Revista
Título do Volume
Editora
EUROPEAN RESPIRATORY SOC JOURNALS LTD
Autores
PENNATI, Francesca
SALITO, Caterina
ALIVERTI, Andrea
Citação
ERJ OPEN RESEARCH, v.4, n.3, article ID UNSP 043, 11p, 2018
Resumo
Small airway and interstitial pulmonary involvements are prominent in chronic hypersensitivity pneumonitis (cHP). However, their roles on exercise limitation and the relationship with functional lung tests have not been studied in detail. Our aim was to evaluate exercise performance and its determinants in cHP. We evaluated maximal cardiopulmonary exercise testing performance in 28 cHP patients (forced vital capacity 57 +/- 17% pred) and 18 healthy controls during cycling. Patients had reduced exercise performance with lower peak oxygen production (16.6 (12.3-19.98) mL.kg(-1).min(-1) versus 25.1 (16.9-32.0), p=0.003), diminished breathing reserve (% maximal voluntary ventilation) (12 (6.4-34.8)% versus 41 (32.7-50.8)%, p<0.001) and hyperventilation (minute ventilation/carbon dioxide production slope 37 +/- 5 versus 31 +/- 4, p<0.001). All patients presented oxygen desaturation and augmented Borg dyspnoea scores (8 (5-10) versus 4 (1-7), p=0.004). The prevalence of dynamic hyperinflation was found in only 18% of patients. When comparing cHP patients with normal and low peak oxygen production (<84% pred, lower limit of normal), the latter exhibited a higher minute ventilation/carbon dioxide production slope (39 +/- 5.0 versus 34 +/- 3.6, p=0.004), lower tidal volume (0.84 (0.78-0.90) L versus 1.15 (0.97-1.67) L, p=0.002), and poorer physical functioning score on the Short form-36 health survey. Receiver operating characteristic curve analysis showed that reduced lung volumes (forced vital capacity %, total lung capacity % and diffusing capacity of the lung for carbon dioxide %) were high predictors of poor exercise capacity. Reduced exercise capacity was prevalent in patients because of ventilatory limitation and not due to dynamic hyperinflation. Reduced lung volumes were reliable predictors of lower performance during exercise.
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Referências
- Arcasoy SM, 2003, AM J RESP CRIT CARE, V167, P735, DOI 10.1164/rccm.200210-1130OC
- Armstrong HF, 2014, RESPIROLOGY, V19, P675, DOI 10.1111/resp.12306
- ATS, 2003, AM J RESP CRIT CARE, V167, P211, DOI 10.1164/rccm.167.2.211
- Baldi BG, 2012, AM J RESP CRIT CARE, V186, P341, DOI 10.1164/rccm.201203-0372OC
- BORG GAV, 1982, MED SCI SPORT EXER, V14, P377, DOI 10.1249/00005768-198205000-00012
- Calverley PMA, 2005, EUR RESPIR J, V25, P186, DOI 10.1183/09031936.04.00113204
- Ciconelli RM, 1999, REV BRAS REUMATOL, V39, P143, DOI 10.1590/S0482-50042010000300005
- Dias OM, 2018, EXPERT REV RESP MED, V12, P5, DOI 10.1080/17476348.2018.1395282
- du Bois RM, 2014, EUR RESPIR J, V43, P1421, DOI 10.1183/09031936.00131813
- Du Plessis JP, 2018, RESPIROLOGY, V23, P392, DOI 10.1111/resp.13226
- Elbehairy AF, 2015, AM J RESP CRIT CARE, V191, P1384, DOI 10.1164/rccm.201501-0157OC
- Erkinjuntti-Pekkanen R, 1998, AM J RESP CRIT CARE, V158, P662, DOI 10.1164/ajrccm.158.2.9710012
- GIBSON GJ, 1977, AM REV RESPIR DIS, V116, P637, DOI 10.1164/arrd.1977.116.4.637
- Guenette JA, 2013, PULM MED, V2013, DOI 10.1155/2013/956081
- Zuniga SG, 2017, RESPIROLOGY, V22, P1637, DOI 10.1111/resp.13124
- Hanak V, 2007, MAYO CLIN PROC, V82, P812, DOI 10.4065/82.7.812
- Hou PC, 2017, CHEST, V152, P22, DOI [10.1016/j.chest.2017.01.010, 10.1016/j.chest.2017.02.011]
- Jensen D, 2009, RESP PHYSIOL NEUROBI, V167, P87, DOI 10.1016/j.resp.2009.01.011
- Lacasse Y, 2003, AM J RESP CRIT CARE, V168, P952, DOI 10.1164/rccm.200301-137OC
- Lacasse Y, 2012, CHEST, V142, P208, DOI 10.1378/chest.11-2479
- Lacasse Y, 2009, INT ARCH ALLERGY IMM, V149, P161, DOI 10.1159/000189200
- LALANCETTE M, 1993, AM REV RESPIR DIS, V148, P216, DOI 10.1164/ajrccm/148.1.216
- Lammi MR, 2015, CURR RESPIR MED REV, V11, P163, DOI 10.2174/1573398X11666150619183527
- Lederer DJ, 2006, AM J RESP CRIT CARE, V174, P659, DOI 10.1164/rccm.200604-520OC
- MacIntyre N, 2005, EUR RESPIR J, V26, P720, DOI 10.1183/09031936.05.00034905
- MARCINIUK DD, 1994, CHEST, V105, P183, DOI 10.1378/chest.105.1.183
- MARCINIUK DD, 1994, J APPL PHYSIOL, V77, P963
- Miller MR, 2005, EUR RESPIR J, V26, P319, DOI 10.1183/09031936.05.00034805
- Nathan SD, 2008, RESP MED, V102, P1305, DOI 10.1016/j.rmed.2008.03.022
- Neder JA, 1999, EUR RESPIR J, V14, P1304, DOI 10.1183/09031936.99.14613049
- Neder JA, 1999, BRAZ J MED BIOL RES, V32, P729, DOI 10.1590/S0100-879X1999000600008
- O'Donnell DE, 2009, EUR RESPIR J, V34, P866, DOI 10.1183/09031936.00168708
- O'Donnell DE, 1998, J APPL PHYSIOL, V84, P2000
- O'Donnell DE, 2001, AM J RESP CRIT CARE, V164, P770, DOI 10.1164/ajrccm.164.5.2012122
- O'Donnell DE, 2000, J APPL PHYSIOL, V88, P1859
- Oliveira RKF, 2014, EUR RESPIR J, V44, P415, DOI 10.1183/09031936.00010414
- Olson AL, 2016, PATIENT-RELAT OUTCOM, V7, P29, DOI 10.2147/PROM.S74857
- Panagiotou M, 2016, CHRON RESP DIS, V13, P162, DOI 10.1177/1479972315626014
- Pereira Carlos Alberto de Castro, 2007, J. bras. pneumol., V33, P397, DOI 10.1590/S1806-37132007000400008
- Rolland-Debord C, 2017, PLOS ONE, V12, DOI 10.1371/journal.pone.0170035
- Russell AM, 2015, BMC MED, V13, DOI 10.1186/s12916-015-0475-4
- Schwaiblmair M, 1997, EUR RESPIR J, V10, P2360, DOI 10.1183/09031936.97.10102360
- SELMANLAMA M, 1993, CLIN CHEST MED, V14, P699
- Silva CIS, 2008, RADIOLOGY, V246, P288, DOI 10.1148/radiol.2453061881
- Silva CIS, 2007, AM J ROENTGENOL, V188, P334, DOI 10.2214/AJR.05.1826
- STUBBING DG, 1980, J APPL PHYSIOL, V49, P511
- Vasakova M, 2017, AM J RESP CRIT CARE, V196, P680, DOI 10.1164/rccm.201611-2201PP
- Vogiatzis I, 2005, THORAX, V60, P723, DOI 10.1136/thx.2004.039115
- Wanger J, 2005, EUR RESPIR J, V26, P511, DOI 10.1183/09031936.05.00035005
- Ware JE, 2000, SPINE, V25, P3130, DOI 10.1097/00007632-200012150-00008
- YERNAULT JC, 1975, B PHYSIO-PATHOL RESP, V11, P231