Use of cardiopulmonary exercise testing to assess early ventilatory changes related to occupational particulate matter

Chao, Tsai Ping; Sperandio, Evandro Fornias; Ostolin, T.L.V.P.; Almeida, Vitória de Cássia Félix de; Romiti, Marcello; Gagliardi, Antônio; Arantes, Rodolfo Leite; Dourado, Victor Zuniga

doi:10.1590/1414-431x20186486

Cited by 6 publications

(6 citation statements)

References 27 publications

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“…When pulmonary alveoli are heavily damaged, and capillary wall becomes increasingly thick, the lung can develop diffuse dysfunction as a result. Therefore, the types of lung function damage commonly found in dust-exposed workers are often restrictive ventilatory dysfunction [23], which is consistent with this study. At the same time, the early damage of inhalable PM 2.5 to the cell membrane can change the permeability of the membrane, which is the main cause of death of alveolar macrophages [24,25].…”

Section: Discussionsupporting

confidence: 91%

Effects of PM2.5 on Cardio-Pulmonary Function Injury in Open Manganese Mine Workers

Huang

Bao

Xiao

et al. 2019

IJERPH

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Exposure to fine particulate matter 2.5 (PM2.5) is associated with adverse health effects, varying by its components. The health-related effects of PM2.5 exposure from ore mining may be different from those of environment pollution. The aim of this study was to investigate the effects of different concentrations of PM2.5 exposure on the cardio-pulmonary function of manganese mining workers. A total of 280 dust-exposed workers who were involved in different types of work in an open-pit manganese mine were randomly selected. According to the different concentrations of PM2.5 in the working environment, the workers were divided into an exposed group and a control group. The electrocardiogram, blood pressure, and multiple lung function parameters of the two groups were measured and analyzed. The PM2.5 exposed group had significantly lower values in the pulmonary function indexes of forced expiratory volume in one second (FEV1.0), maximum mid expiratory flow (MMEF), peak expiratory flow rate (PEFR), percentage of peak expiratory flow out of the overall expiratory flow volume (PEFR%), forced expiratory flow at 25% and 75% of forced vital capacity (FEF 25, FEF75), forced expiratory flow when 25%, 50%, and 75% of forced vital capacity has been exhaled (FEF25%,FEF50%, FEF75%), and FEV1.0/FVC% (the percentage of the predicted value of forced vital capacity) than the control group (all p < 0.05). Both groups had mild or moderate lung injury, most of which was restrictive ventilatory disorder, and there was significant difference in the prevalence rate of restrictive respiratory dysfunction between the two groups (41.4% vs. 23.6%, p = 0.016). Electrocardiogram (ECG) abnormalities, especially sinus bradycardia, were shown in both groups, but there was no statistical difference of the prevalence rate between the two groups (p > 0.05). Also, no significant difference of the prevalence rate of hypertension was observed between the PM2.5 exposure and control groups (p > 0.05). PM2.5 exposure was associated with pulmonary function damage of the workers in the open-pit manganese mine, and the major injury was restrictive ventilatory disorder. The early effect of PM2.5 exposure on the cardiovascular system was uncertain at current exposure levels and exposure time.

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Section: Discussionsupporting

confidence: 91%

Effects of PM2.5 on Cardio-Pulmonary Function Injury in Open Manganese Mine Workers

Huang

Bao

Xiao

et al. 2019

IJERPH

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“…Moreover, we obtained direct measurements of CRF and MVPA respectively through the CPET and triaxial accelerometry. A previous study suggests that the CPET is more sensitive than spirometry to early diagnosis of incipient ventilatory changes [ 56 ], which further strengthens the measures performed in our study and reinforces the applicability of the CRF assessment in clinical practice.…”

Section: Discussionsupporting

confidence: 86%

Mediator Effect of Cardiorespiratory Fitness on the Association between Physical Activity and Lung Function in Adults: Cross-Sectional Results from the Epimov Study

Ostolin

Gonze

Sperandio

et al. 2022

IJERPH

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We investigated whether cardiorespiratory fitness (CRF) mediates the association between moderate-to-vigorous physical activity (MVPA) and lung function in asymptomatic adults. We examined the cross-sectional results of 1362 adults aged 18–80 years from the Epidemiology and Human Movement Study. Participants were submitted to spirometry to obtain forced vital capacity (FVC) and forced expiratory volume in 1s (FEV1). Additionally, we used cardiopulmonary exercise testing to obtain peak oxygen uptake (V˙O2) as a measure of CRF. Participants used a triaxial accelerometer for 4–7 days to obtain MVPA. Mediation analyses were performed considering the CRF as a mediator, MVPA as an independent variable, and FVC and FEV1 as dependent variables with adjustment for age, sex, and cardiovascular risk score. We aimed to investigate the total (path c) and direct (paths a, b, c’) effects through the regression coefficients. We also examined the indirect effect, which was obtained from the product of the coefficients (path ab). Our sample was composed mainly of overweight and middle-aged women. MVPA was positively related to CRF (path a), as well as CRF and lung function (path b). MVPA also presented a significant positive total effect (path c) in the lung function. However, this relationship became non-significant when CRF was included in the model for both FVC and FEV1 (path c’). We did not observe a direct effect of MVPA on the lung function. In contrast, the indirect effect was significant (path ab). Lastly, CRF mediated 60% of the total effect of MVPA on FVC and 61.9% on FEV1. CRF mediates the relationship between lung function and MVPA in asymptomatic adults. Therefore, our results reinforce the need to include CRF assessment in practice clinical routine and suggest that strategies focusing on CRF might be more promising to prevent respiratory diseases in adults.

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“…In this context, lower values of this ratio, indicative of tachypnea respiratory pattern, would most likely suggest an incipient ventilatory disorder regardless of obesity severity. Recently, Chao et al [ 39 ] compared spirometry and CPET to detect incipient ventilatory disorders in workers exposed or not to occupational particulate matter. In addition to best sensibility of CPET, the was one of the most useful variables being able to differentiate exposed from unexposed workers.…”

Section: Discussionmentioning

confidence: 99%

Dynamic physiological responses in obese and non-obese adults submitted to cardiopulmonary exercise test

et al. 2021

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Purpose Obese individuals have reduced performance in cardiopulmonary exercise testing (CPET), mainly considering peak values of variables such as oxygen uptake (V˙O2), carbon dioxide production (V˙CO2), tidal volume (Vt), minute ventilation (V˙E) and heart rate (HR). The CPET interpretation and prognostic value can be improved through submaximal ratios analysis of key variables like ΔHR/ΔV˙O2, ΔV˙E/ΔV˙CO2, ΔV˙C/Δlinearized (ln)V˙E and oxygen uptake efficiency slope (OUES). The obesity influence on these responses has not yet been investigated. Our purpose was to evaluate the influence of adulthood obesity on maximal and submaximal physiological responses during CPET, emphasizing the analysis of submaximal dynamic variables. Methods We analyzed 1,594 CPETs of adults (755 obese participants, Body Mass Index ≥ 30 kg/m2) and compared the obtained variables among non-obese (normal weight and overweight) and obese groups (obesity classes I, II and III) through multivariate covariance analyses. Result Obesity influenced the majority of evaluated maximal and submaximal responses with worsened CPET performance. Cardiovascular, metabolic and gas exchange variables were the most influenced by obesity. Other maximal and submaximal responses were altered only in morbidly obese. Only a few cardiovascular and ventilatory variables presented inconsistent results. Additionally, Vtmax, Vt/V˙E, Vt/Inspiratory Capacity, Vt/Forced Vital Capacity, Lowest V˙E/V˙CO2, ΔV˙E/ΔV˙CO2, and the y-intercepts of V˙E/V˙CO2 did not significantly differ regardless of obesity. Conclusion Obesity expressively influences the majority of CPET variables. However, the prognostic values of the main ventilatory efficiency responses remain unchanged. These dynamic responses are not dependent on maximum effort and may be useful in detecting incipient ventilatory disorder. Our results present great practical applicability in identifying exercise limitation, regardless of overweight and obesity.

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Use of cardiopulmonary exercise testing to assess early ventilatory changes related to occupational particulate matter

Cited by 6 publications

References 27 publications

Effects of PM2.5 on Cardio-Pulmonary Function Injury in Open Manganese Mine Workers

Effects of PM2.5 on Cardio-Pulmonary Function Injury in Open Manganese Mine Workers

Mediator Effect of Cardiorespiratory Fitness on the Association between Physical Activity and Lung Function in Adults: Cross-Sectional Results from the Epimov Study

Dynamic physiological responses in obese and non-obese adults submitted to cardiopulmonary exercise test

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