Responses to exercise in systemic sclerosis-associated interstitial lung disease.

Autor: Donnelly RP; Royal Victoria Hospital, Belfast, Northern Ireland., Smyth AE; Department of Rheumatology, Ulster Hospital, Dundonald, Northern Ireland., Mullan C; City Hospital, Belfast, Northern Ireland., Riley MS; City Hospital, Belfast, Northern Ireland., Nicholls DP; Royal Victoria Hospital, Belfast, Northern Ireland.
Jazyk: angličtina
Zdroj: Clinical physiology and functional imaging [Clin Physiol Funct Imaging] 2023 Jul; Vol. 43 (4), pp. 253-262. Date of Electronic Publication: 2023 Feb 14.
DOI: 10.1111/cpf.12813
Abstrakt: Introduction: Pulmonary 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.
Methods: Fifteen 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.
Results: Patients with SSc-ILD had lower exercise capacity than SSc patients without ILD or normal subjects (peak oxygen consumption (PV̇O 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 PV̇O 2 did not correlate with static pulmonary function measurements. Ventilatory equivalent for CO 2 (V̇E/V̇CO 2 ; 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.
Conclusions: SSc-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.
(© 2023 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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