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Reduction of exercise capacity in sarcoidosis in relation to disease severity.

Kallianos A, Zarogoulidis P, Ampatzoglou F, Trakada G, Gialafos E, Pitsiou G, Pataka A, Veletza L, Zarogoulidis K, Hohenforst-Schmidt W, Petridis D, Kioumis I, Rapti A - Patient Prefer Adherence (2015)

Bottom Line: Forced expiratory volume in 1 second, forced vital capacity, and total lung capacity were mildly impaired only in Stage IV (means ± standard deviation: 72.44±28.00, 71.33±26.70, and 59.78±21.72, respectively), while DLCO was mildly and moderately reduced in Stages II-III and IV (72.68±14.13 and 51.22±18.50, respectively) and differed significantly between all stages (I vs II-III: P=0.003, I vs IV: P=0.003, and II-III vs IV: P=0.009).Exercise capacity (as expressed by peak oxygen consumption <84% predicted) was decreased in 53% of patients (Stage I: 48%, Stages II-III: 52%, Stage IV: 78%); however, significant differences were noticed only between Stages I and IV (P=0.0025).Of note, significant correlations were found between peak oxygen consumption and DLCO (P=0.0083), minute ventilation (P<0.0001), oxygen pulse (P<0.0001), lactate threshold (P<0.0001), and peak ventilatory threshold (P<0.0001).

View Article: PubMed Central - PubMed

Affiliation: 2nd Pulmonary Department, Sotiria Chest Diseases Hospital, Athens, Greece.

ABSTRACT

Introduction: Pulmonary function tests (PFTs) do not always predict functional limitations during exercise in sarcoidosis. Cardiopulmonary exercise testing (CPET) may facilitate the recognition of exercise intolerance in these patients.

Aim: As relevant data in sarcoid patients are limited, the aim of the study reported here was to assess exercise capacity impairment during a maximal CPET and to evaluate potential correlations with PFT measurements and radiological stages of the disease.

Method: A total of 83 sarcoid patients consecutively referred for evaluation of exertional dyspnea over a 3-year period were studied retrospectively with PFTs, including spirometry, diffusing capacity of the lung for carbon monoxide (DLCO) and lung volumes, and CPET using standard protocol. Patients were grouped according to their radiological stages: Stage I (n=43), Stages II-III (n=31), and Stage IV (n=9).

Results: Forced expiratory volume in 1 second, forced vital capacity, and total lung capacity were mildly impaired only in Stage IV (means ± standard deviation: 72.44±28.00, 71.33±26.70, and 59.78±21.72, respectively), while DLCO was mildly and moderately reduced in Stages II-III and IV (72.68±14.13 and 51.22±18.50, respectively) and differed significantly between all stages (I vs II-III: P=0.003, I vs IV: P=0.003, and II-III vs IV: P=0.009). Exercise capacity (as expressed by peak oxygen consumption <84% predicted) was decreased in 53% of patients (Stage I: 48%, Stages II-III: 52%, Stage IV: 78%); however, significant differences were noticed only between Stages I and IV (P=0.0025). Of note, significant correlations were found between peak oxygen consumption and DLCO (P=0.0083), minute ventilation (P<0.0001), oxygen pulse (P<0.0001), lactate threshold (P<0.0001), and peak ventilatory threshold (P<0.0001).

Conclusion: CPET could be considered a useful tool in exercise intolerance evaluation in sarcoid patients with mild PFT abnormalities. Exercise limitation in sarcoidosis may be attributed to both ventilatory and cardiocirculatory impairment.

No MeSH data available.


Related in: MedlinePlus

VO2 peak correlations with clinical, functional, and cardiopulmonary test parameters in 83 patients with sarcoidosis.Note:P<0.001 for all comparisons.Abbreviations: FVC%, percent forced vital capacity; %pred, percent predicted; AT, anaerobic threshold; DLCO, diffusing capacity of the lung for carbon monoxide; VE, minute ventilation; VO2 peak, peak oxygen consumption; VT, tidal volume.
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f1-ppa-9-1179: VO2 peak correlations with clinical, functional, and cardiopulmonary test parameters in 83 patients with sarcoidosis.Note:P<0.001 for all comparisons.Abbreviations: FVC%, percent forced vital capacity; %pred, percent predicted; AT, anaerobic threshold; DLCO, diffusing capacity of the lung for carbon monoxide; VE, minute ventilation; VO2 peak, peak oxygen consumption; VT, tidal volume.

Mentions: Among the whole population, significant correlations (P<0.001) were found between VO2 peak and age, DLCO, VE, oxygen pulse, lactate threshold, and VT peak (Figure 1). Correlations of VO2 peak in relation to the radiological stages of the disease are summarized in Table 3. Of note, both functional parameters (FEV1, FVC, FEF25–75) and HR peak were found to be significant predictors of exercise capacity only in Stages II+II, whereas exercise limitation in Stage IV was related mainly to physiological impairment due to ventilatory parameters.


Reduction of exercise capacity in sarcoidosis in relation to disease severity.

Kallianos A, Zarogoulidis P, Ampatzoglou F, Trakada G, Gialafos E, Pitsiou G, Pataka A, Veletza L, Zarogoulidis K, Hohenforst-Schmidt W, Petridis D, Kioumis I, Rapti A - Patient Prefer Adherence (2015)

VO2 peak correlations with clinical, functional, and cardiopulmonary test parameters in 83 patients with sarcoidosis.Note:P<0.001 for all comparisons.Abbreviations: FVC%, percent forced vital capacity; %pred, percent predicted; AT, anaerobic threshold; DLCO, diffusing capacity of the lung for carbon monoxide; VE, minute ventilation; VO2 peak, peak oxygen consumption; VT, tidal volume.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4547650&req=5

f1-ppa-9-1179: VO2 peak correlations with clinical, functional, and cardiopulmonary test parameters in 83 patients with sarcoidosis.Note:P<0.001 for all comparisons.Abbreviations: FVC%, percent forced vital capacity; %pred, percent predicted; AT, anaerobic threshold; DLCO, diffusing capacity of the lung for carbon monoxide; VE, minute ventilation; VO2 peak, peak oxygen consumption; VT, tidal volume.
Mentions: Among the whole population, significant correlations (P<0.001) were found between VO2 peak and age, DLCO, VE, oxygen pulse, lactate threshold, and VT peak (Figure 1). Correlations of VO2 peak in relation to the radiological stages of the disease are summarized in Table 3. Of note, both functional parameters (FEV1, FVC, FEF25–75) and HR peak were found to be significant predictors of exercise capacity only in Stages II+II, whereas exercise limitation in Stage IV was related mainly to physiological impairment due to ventilatory parameters.

Bottom Line: Forced expiratory volume in 1 second, forced vital capacity, and total lung capacity were mildly impaired only in Stage IV (means ± standard deviation: 72.44±28.00, 71.33±26.70, and 59.78±21.72, respectively), while DLCO was mildly and moderately reduced in Stages II-III and IV (72.68±14.13 and 51.22±18.50, respectively) and differed significantly between all stages (I vs II-III: P=0.003, I vs IV: P=0.003, and II-III vs IV: P=0.009).Exercise capacity (as expressed by peak oxygen consumption <84% predicted) was decreased in 53% of patients (Stage I: 48%, Stages II-III: 52%, Stage IV: 78%); however, significant differences were noticed only between Stages I and IV (P=0.0025).Of note, significant correlations were found between peak oxygen consumption and DLCO (P=0.0083), minute ventilation (P<0.0001), oxygen pulse (P<0.0001), lactate threshold (P<0.0001), and peak ventilatory threshold (P<0.0001).

View Article: PubMed Central - PubMed

Affiliation: 2nd Pulmonary Department, Sotiria Chest Diseases Hospital, Athens, Greece.

ABSTRACT

Introduction: Pulmonary function tests (PFTs) do not always predict functional limitations during exercise in sarcoidosis. Cardiopulmonary exercise testing (CPET) may facilitate the recognition of exercise intolerance in these patients.

Aim: As relevant data in sarcoid patients are limited, the aim of the study reported here was to assess exercise capacity impairment during a maximal CPET and to evaluate potential correlations with PFT measurements and radiological stages of the disease.

Method: A total of 83 sarcoid patients consecutively referred for evaluation of exertional dyspnea over a 3-year period were studied retrospectively with PFTs, including spirometry, diffusing capacity of the lung for carbon monoxide (DLCO) and lung volumes, and CPET using standard protocol. Patients were grouped according to their radiological stages: Stage I (n=43), Stages II-III (n=31), and Stage IV (n=9).

Results: Forced expiratory volume in 1 second, forced vital capacity, and total lung capacity were mildly impaired only in Stage IV (means ± standard deviation: 72.44±28.00, 71.33±26.70, and 59.78±21.72, respectively), while DLCO was mildly and moderately reduced in Stages II-III and IV (72.68±14.13 and 51.22±18.50, respectively) and differed significantly between all stages (I vs II-III: P=0.003, I vs IV: P=0.003, and II-III vs IV: P=0.009). Exercise capacity (as expressed by peak oxygen consumption <84% predicted) was decreased in 53% of patients (Stage I: 48%, Stages II-III: 52%, Stage IV: 78%); however, significant differences were noticed only between Stages I and IV (P=0.0025). Of note, significant correlations were found between peak oxygen consumption and DLCO (P=0.0083), minute ventilation (P<0.0001), oxygen pulse (P<0.0001), lactate threshold (P<0.0001), and peak ventilatory threshold (P<0.0001).

Conclusion: CPET could be considered a useful tool in exercise intolerance evaluation in sarcoid patients with mild PFT abnormalities. Exercise limitation in sarcoidosis may be attributed to both ventilatory and cardiocirculatory impairment.

No MeSH data available.


Related in: MedlinePlus