Exercise responses are related to structural lung damage in CF pulmonary disease

• Published in: Pediatric pulmonology Vol. 51; no. 9; pp. 914 - 920
• Main Authors: Hatziagorou, Elpis, Kampouras, Asterios, Avramidou, Vasiliki, Georgopoulou, Vasiliki, Kirvasilis, Fotis, Kontouli, Kalliopi, Hebestreit, Helge, Tsanakas, John
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2016; Wiley Subscription Services, Inc
• Subjects: Adolescent; cardiopulmonary exercise testing; children; cystic fibrosis; Cystic Fibrosis - diagnostic imaging; Cystic Fibrosis - pathology; Cystic Fibrosis - physiopathology; Disease Progression; Exercise Test; Female; Forced Expiratory Volume - physiology; HRCT; Humans; Lung - diagnostic imaging; Lung - pathology; Lung - physiopathology; Male; Oxygen Consumption - physiology; Retrospective Studies; Spirometry; Tomography, X-Ray Computed; HRCT; spirometry; cardiopulmonary exercise testing; children; cystic fibrosis
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.23474

Summary Introduction Early detection of lung disease is a primary objective in monitoring patients with Cystic Fibrosis (CF); High‐Resolution‐Computed‐Tomography (HRCT) assesses structural damage. Spirometry and cardiopulmonary exercise testing are used for functional evaluation of CF lung disease. Aim To evaluate the deterioration of exercise testing parameters over a 2‐year period compared to the change of spirometry and HRCT parameters among CF patients. Methods Twenty‐eight CF patients were evaluated with HRCT, spirometry, and exercise testing; 15 had two assessments with an interval of 2 years. Correlation analyses between Bhalla score parameters and functional measures were performed. Results Twenty‐eight patients with CF (mean age 14.9 years, mean forced expiratory volume in 1 sec [FEV1] 83.2%) were evaluated. FEV1 was not found to change significantly in the 2‐year period (P = 0.612). Both mean Bhalla score and mean peak oxygen consumption (VO2 peak %) deteriorated significantly (P = 0.014 and P = 0.026, respectively). VO2 peak and respiratory equivalents for O2 and CO2 at peak exercise were found to be significant predictors of Bhalla score (r = −0.477, P = 0.010; r = 0.461, P = 0.018; r = 0.402; P = 0.042, respectively). Anaerobic threshold was associated with changes in Bhalla score over the following 2 years. Conclusions Exercise testing is more sensitive than spirometry to detect structural changes in CF lungs. Pediatr Pulmonol. 2016; 51:914–920. © 2016 Wiley Periodicals, Inc.