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Ventilatory Threshold and Risk of Pulmonary Exacerbations in Cystic Fibrosis.
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- Author(s): Campos, Natália E.; Vendrusculo, Fernanda M.; Pérez-Ruiz, Margarita; Donadio, Márcio V. F.
- Source:
Respiratory Care; May2023, Vol. 68 Issue 5, p620-627, 8p- Subject Terms:
ANTIBIOTICS; EXERCISE tests; STATISTICS; AEROBIC exercises; LUNG diseases; CARDIOPULMONARY system; ANTHROPOMETRY; OXYGEN consumption; MULTIVARIATE analysis; PHYSICAL fitness; RETROSPECTIVE studies; CYSTIC fibrosis; PEARSON correlation (Statistics); PULMONARY function tests; FORCED expiratory volume; CARBON dioxide; DESCRIPTIVE statistics; DATA analysis software; DISEASE exacerbation; ANAEROBIC threshold; LONGITUDINAL method; PROPORTIONAL hazards models; DISEASE risk factors; DISEASE complications - Source:
- Additional Information
- Subject Terms:
- Abstract: BACKGROUND: Whereas pulmonary exacerbations and aerobic fitness play a key role in the prognosis of cystic fibrosis (CF), the use of ventilatory threshold data as markers of exacerbation risk has been scarcely addressed. This study sought to examine the association between aerobic fitness, assessed through ventilatory threshold variables recorded during cardiopulmonary exercise testing (CPET), and the risk of exacerbations in individuals with CF. METHODS: Participants of this retrospective cohort study were subjects from 6 y of age. Over a 4-y period, the following data were recorded: lung function indicators, CPET variables, time to first exacerbation and antibiotic use, along with demographic, clinical, and anthropometric data. RESULTS: The mean age of 20 subjects included was 16 ± 5.4 y. Univariate regression analysis revealed that lung function (FEV1: Cox hazard ratio [HR] 0.97, P = .03; and forced expiratory flow between 25-75% of vital capacity [FEF
25-75 ]: Cox HR 0.98, P = .036) and aerobic fitness (oxygen consumption [...O 2 ] at ventilatory threshold: Cox HR 0.94, P = .01; and ventilatory equivalent for carbon dioxide [...E /...CO 2 ] at ventilatory threshold: Cox HR 1.13, P = .049) were associated with exacerbation risk, whereas in the multivariate model, only ...O 2 at the ventilatory threshold (%max) (Cox HR 0.92, P = .01) had a significant impact on this risk. Consistently, individuals experiencing exacerbation had significantly lower ...O 2 values (%max) at the ventilatory threshold (P = .050) and higher ventilatory equivalent for oxygen consumption (...E /...O 2 ) (P = .040) and ...E /...O 2 (P = .037) values at the ventilatory threshold. Time to exacerbation was significantly correlated with ...O 2 at the ventilatory threshold (r = 0.50, P = .02), ...E /...O 2 (r = -0.48, P = .02), and ...E /...CO 2 (r = -0.50, P = .02). CONCLUSIONS: Our results suggest an association between CPET variables at the ventilatory threshold and exacerbations. Percentage ...O 2 at the ventilatory threshold could serve as a complementary variable to monitor exacerbations in people with CF. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Respiratory Care is the property of American Association for Respiratory Care and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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