Autologous stem cell transplantation improves cardiopulmonary exercise testing outcomes in systemic sclerosis patients.

Autor:	Gadioli LP; Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School., Costa-Pereira K; Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo., Dias JBE; Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo., Moraes DA; Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo., Crescêncio JC; Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School., Schwartzmann PV; Cardiology Unit, Unimed Hospital.; CAPED Research Center., Gallo-Júnior L; Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School., Schmidt A; Division of Cardiology, Department of Internal Medicine, Ribeirão Preto Medical School., Oliveira MC; Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo.; Center for Cell-based Therapy, Regional Hemotherapy Center of the Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2023 Feb 06; Vol. 62 (SI), pp. SI101-SI106.
DOI:	10.1093/rheumatology/keac413
Abstrakt:	Objectives: Autologous haematopoietic stem cell transplantation (AHSCT) is a disease-modifying treatment for patients with severe SSc. Here, we aimed at assessing cardiopulmonary function outcomes of SSc patients after AHSCT. Methods: Twenty-seven SSc adult patients treated with AHSCT were included in this retrospective study. Most had the diffuse cutaneous subset (93%) and pulmonary involvement (85%). Before and 12 months after AHSCT, patients underwent cardiopulmonary exercise testing, transthoracic echocardiography, pulmonary function test with diffusing capacity for carbon monoxide (DLCO), 6-min walk test (6MWT) and quality of life evaluations. Results: After AHSCT, the peak VO2 increased from 954 to 1029 ml/min (P = 0.02), the percentage of predicted peak VO2 increased from 48.9 to 53.5 m (P = 0.01), and the distance measured by the 6MWT increased from 445 to 502 m (P = 0.01), compared with baseline. Improvements in peak VO2 correlated positively with improvements in 6MWT distance, and negatively with a decrease in resting heart rate. At baseline, patients with DLCO >70% had higher peak VO2 values than those with DLCO <70% (P = 0.04), but after AHSCT all patients showed improved VO2 values, regardless of baseline DLCO levels. Increases in VO2 levels after AHSCT positively correlated with increases in the physical component scores of the Short Form-36 quality of life questionnaire (r = 0.70; P = 0.0003). Conclusion: AHSCT improves the aerobic capacity of SSc patients probably reflecting combined increments in lungs, skeletal muscle and cardiac function. (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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