Cardiopulmonary exercise testing in patients with asthma: What is its clinical value?

Boutou, Afroditi; Daniil, Zoi; Pitsiou, Georgia; Papakosta, Despoina; Kioumis, Ioannis; Stanopoulos, Ioannis

doi:10.1016/j.rmed.2020.105953

Cited by 15 publications

(12 citation statements)

References 103 publications

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“…A recent review on the clinical value of CPET in patients with asthma has shown that the majority of available studies are in patients with mild-to-moderate disease and adults (13). Studies in children with mild asthma have shown no aerobic fitness compromise (12,14).…”

Section: Introductionmentioning

confidence: 99%

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

et al. 2020

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Objective: To evaluate the exercise capacity of children and adolescents with severe therapy resistant asthma (STRA) aiming to identify its main determinants. Methods: Cross-sectional study including individuals aged 6-18 years with a diagnosis of STRA. Clinical (age and gender), anthropometric (weight, height and body mass index) and disease control data were collected. Lung function (spirometry), cardiopulmonary exercise testing (CPET) and exercise-induced bronchoconstriction (EIB) test were performed. Results: Twenty-four patients aged 11.5 ± 2.6 years were included. The mean forced expiratory volume in one second (FEV 1 ) was 91.3 ± 9.2%. EIB occurred in 54.2% of patients. In CPET, the peak oxygen uptake (VO 2peak ) was 34.1 ± 7.8 mL kg À1 min À1 . A significant correlation between ventilatory reserve and FEV 1 (r ¼ 0.57; p ¼ 0.003) was found. Similarly, there was a significant correlation between CPET and percent of FEV 1 fall in the EIB test for both V E /VO 2 (r ¼ 0.47; p ¼ 0.02) and V E /VCO 2 (r ¼ 0.46; p ¼ 0.02). Patients with FEV 1 <80% had lower ventilatory reserve (p ¼ 0.009). In addition, resting heart rate correlated with VO 2peak (r¼-0.40; p ¼ 0.04), V E /VO 2 (r ¼ 0.46; p ¼ 0.02) and V E /VCO 2 (r ¼ 0.48; p ¼ 0.01). Conclusions: Exercise capacity is impaired in approximately 30% of children and adolescents with STRA. The results indicate that different aspects of aerobic fitness are influenced by distinct determinants, including lung function and EIB.

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Section: Introductionmentioning

confidence: 99%

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

et al. 2020

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“…A recent review by B outou et al . [ 21 ] reported data about ventilation/perfusion inequality induced by physical exercise in asthmatic patients. The uneven ventilation and the ventilation/perfusion inequality could be explained by bronchoconstriction and airways inflammation, since arterial p O 2 and the alveolar to arterial oxygen pressure difference (A-aDO2) were negatively correlated to the increase in histamine concentration in sputum, as demonstrated by H averkamp and colleagues [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular limitation was distinguished by low V ′ O 2 peak and low O 2 pulse, normal breathing reserve and no sign of desaturation. Respiratory limitation was characterised by low V ′ O 2 peak, desaturation and/or breathing reserve depletion [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…Cardiovascular limitation was distinct by low V´O2 peak and low O2-pulse, normal breathing reserve and no sign of desaturation. Respiratory limitation was characterized by low V´O2 peak, desaturation and/or breathing reserve depletion [21,22]. Dynamic hyperinflation (DH) was defined as elevation of EELV ≥ 0.250 L during exercise and decrease of IC > 0.2 L [10,21].…”

Section: Definitionsmentioning

confidence: 99%

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The impact of anti-eosinophilic therapy on exercise capacity and inspiratory muscle strength in patients with severe asthma

Franceschi¹,

Drick²,

Fuge³

et al. 2023

ERJ Open Res

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IntroductionExercise limitation is frequently described among asthmatic patients and could be related to different mechanisms of the pulmonary, cardiovascular and muscular systems. Despite this, cardiopulmonary exercise testing (CPET) does not have an established role in the management of severe asthma. The aim of our study was to investigate the role of CPET and inspiratory pressure measurement in exercise capacity and muscle strength in severe asthmatic patients treated with anti-IL-5 therapy.MethodsA monocentric observational study was conducted at Hanover Medical School, Germany, from April 2018 to June 2019. Patients affected by severe asthma treated with either mepolizumab or benralizumab were included. All patients underwent CPET before the initiation of antibody therapy and after 3 months, and follow-up visits were scheduled at 3, 6 and 12 months with plethysmography, inspiratory pressure measurement and blood gas analysis.Results14 patients were enrolled: 10 (71.4%) females, median age 52 years (IQR 47–61). Seven patients were treated with benralizumab, seven with mepolizumab. Oxygen uptake (V′O2peak) did not change significantly after 3 months of antibody treatment, while the mean value of the breathing reserve exhaustion reduced significantly from 78% to 60% (p=0.004). Whereas at baseline seven patients depleted the breathing reserve and two of them experienced oxygen desaturation during exercise, at 3 months no one presented any desaturation or breathing reserve exhaustion. The inspiratory pressure remained unchanged before and after the antibody therapy.ConclusionCPET could show hints of alveolar recruitment and ventilatory efficiency in severe asthma patients treated with antibody therapy.

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“…CPET has been widely carried out in patients with pulmonary hypertension (PH), heart failure (HF), chronic obstructive lung disease (COPD), asthma, etc. [ 3 – 5 ]. It has been reported to be of significance in disease diagnosis, therapeutic efficacy evaluation and prognostic assessment.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary exercise testing and pulmonary function testing for predicting the severity of CTEPH

et al. 2021

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Background Cardiopulmonary exercise testing (CPET) and pulmonary function testing (PFT) are noninvasive methods to evaluate the respiratory and circulatory systems. This research aims to evaluate and monitor chronic thromboembolic pulmonary hypertension (CTEPH) noninvasively and effectively by these two methods. Moreover, the research assesses the predictive value of CPET and PFT parameters for severe CTEPH. Methods We used data from 86 patients with CTEPH (55 for test set, and 31 for validation set) at the Shanghai Pulmonary Hospital Affiliated to Tongji University. The clinical, PFT and CPET data of CTEPH patients of different severity classified according to pulmonary artery pressure (PAP) (mm Hg) were collected and compared. Logistic regression analysis was performed to appraise the predictive value of each PFT and CPET parameter for severe CTEPH. The performance of CPET parameters for predicting severe CTEPH was determined by receiver operating characteristic (ROC) curves and calibration curves. Results Data showed that minute ventilation at anaerobic threshold (VE @ AT) (L/min) and oxygen uptake at peak (VO2 @ peak) (mL/kg/min) were independent predictors for severe CTEPH classified according to PAP (mm Hg). Additionally, the efficacy of VE @ AT (L/min) and VO2 @ peak (mL/kg/min) in identifying severe CTEPH was found to be moderate with the area under ROC curve (AUC) of 0.769 and 0.740, respectively. Furthermore, the combination of VE @ AT (L/min) and VO2 @ peak (mL/kg/min) had a moderate utility value in identifying severe CTEPH with the AUC of 0.843. Conclusion Our research suggests that CPET and PFT can noninvasively and effectively evaluate, monitor and predict the severity of CTEPH.

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Cardiopulmonary exercise testing in patients with asthma: What is its clinical value?

Cited by 15 publications

References 103 publications

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

The impact of anti-eosinophilic therapy on exercise capacity and inspiratory muscle strength in patients with severe asthma

Cardiopulmonary exercise testing and pulmonary function testing for predicting the severity of CTEPH

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