Title :

Limited Exercise Capacity in Patients with Systemic Sclerosis: Identifying Contributing Factors with Cardiopulmonary Exercise Testing

Author(s) :

Martis, Nihal [Auteur]
Queyrel-Moranne, Viviane [Auteur]
Launay, David [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Nevière, Rémi [Auteur]
Fuzibet, Jean-Gabriel [Auteur]
Marquette, Charles-Hugo [Auteur]
Leroy, Sylvie [Auteur]

Journal title :

The Internet Journal of Rheumatology

Abbreviated title :

J. Rheumatol.

Volume number :

45

Pages :

95-102

Publication date :

2018-01-01

ISSN :

0315-162X

Keyword(s) :

MUSCULOSKELETAL PHYSIOLOGICAL PHENOMENA
PULMONARY FIBROSIS
DYSPNEA
SYSTEMIC SCLEROSIS
EXERCISE TEST
PULMONARY GAS EXCHANGE

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective. Exercise limitation in patients with systemic sclerosis (SSc) is often multifactorial and related to complications such as interstitial lung disease (ILD), pulmonary vasculopathy (PV), left ventricular dysfunction ...
Show more >Objective. Exercise limitation in patients with systemic sclerosis (SSc) is often multifactorial and related to complications such as interstitial lung disease (ILD), pulmonary vasculopathy (PV), left ventricular dysfunction (LVD), and/or peripheral/muscular limitation (PML). We hypothesized that cardiopulmonary exercise testing (CPET) could not only suggest and rank competing etiologies, but also highlight peripheral impairment. Methods. Clinical, resting pulmonary function testing, and CPET data from patients with SSc referred for exercise limitation between October 2009 and November 2015 were retrospectively analyzed in this bi-center study. Patients were categorized as having ILD, PV, LVD, and/or PML based on CPET response patterns and the diagnoses were matched with results from the reference investigations. The latter consisted of transthoracic echocardiography, chest computed tomography scan, and right heart catheterization (RHC). Results. Twenty-seven patients presented with CPET profiles consistent with ILD (n = 16), PV (n = 15), LVD (n = 5), and PML (n = 19). None of the subjects had a normal CPET profile. There was a statistically significant negative correlation between resting DLCO, on the one hand, and dead space to tidal volume ratio and alveolar–arterial gradient [P(Ai-a)O2] on the other (p < 0.005). CPET identified 90% of patients with a mean pulmonary arterial pressure at rest ≥ 21 mmHg measured by RHC (n = 10). Peak P(Ai-a)O2, taken independently from other variables, was crucial in distinguishing subjects with ILD from those without ILD (p < 0.05). Conclusion. CPET is useful for the characterization of multifactorial exercise limitation in patients with SSc and in identifying SSc-related complications such as ILD and PV. This study also identifies PML as an underestimated cause of exercise limitation.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:35:16Z
2023-12-04T10:26:24Z