scholarly journals Desaturation-Distance Ratio During Submaximal and Maximal Exercise Tests and Its Association With Lung Function Parameters in Patients With Lymphangioleiomyomatosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Douglas Silva Queiroz ◽  
Cibele Cristine Berto Marques da Silva ◽  
Alexandre Franco Amaral ◽  
Martina Rodrigues Oliveira ◽  
Henrique Takachi Moriya ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Field Tests ◽  
Interstitial Lung Diseases ◽  
Functional Evaluation ◽  
Air Trapping ◽  
Exercise Tests ◽  
Distance Ratio ◽  
Cross Sectional ◽  
Walking Test

Background: The desaturation–distance ratio (DDR), the ratio of the desaturation area to the distance walked, is a promising, reliable, and simple physiologic tool for functional evaluation in subjects with interstitial lung diseases. Lymphangioleiomyomatosis (LAM) is a rare neoplastic condition frequently associated with exercise impairment. However, DDR has rarely been evaluated in patients with LAM.Objectives: To assess DDR during maximal and submaximal exercises and evaluate whether DDR can be predicted using lung function parameters.Methods: A cross-sectional study was conducted in a cohort of women with LAM. The 6-min walking test (6MWT) and the incremental shuttle walking test (ISWT) were performed, and DDR was obtained from both tests. The functional parameters were assessed at rest using spirometry and body plethysmography. The pulmonary function variables predictive of DDR were also assessed.Results: Forty patients were included in this study. The mean age was 46 ± 10 years. Airway obstruction, reduced DLCO, and air trapping were found in 60, 57, and 15% of patients, respectively. The distance walked and the DDR for the 6MWT and ISWT were, respectively, 517 ± 65 and 443 ± 127 m; and 6.6 (3.8–10.9) and 8.3 (6.2–12.7). FEV1 (airway obstruction) and reduced DLCO and RV/TLC (air trapping) were independent variables predictive of DDR during exercises field tests [DDR6MWT = 18.66–(0.06 × FEV1%pred)–(0.10 × DLCO%pred) + (1.54 × air trapping), Radjust2 = 0.43] and maximal [DDRISWT = 18.84–(0.09 × FEV1%pred)–(0.05 × DLCO%pred) + (3.10 × air trapping), Radjust2 = 0.33].Conclusion: Our results demonstrated that DDR is a useful tool for functional evaluation during maximal and submaximal exercises in patients with LAM, and it can be predicted using airway obstruction, reduced DLCO, and air trapping.

scholarly journals VENTILATORY AND METABOLIC RESPONSES DURING FIELD TESTS AND CPX IN OBESE ADULTS

2017 ◽  
Vol 25 (1) ◽  
pp. 168
Author(s):  
Nicole Oliver ◽  
Renata Carlos ◽  
Tatiana Onofre ◽  
Joceline Cássia Ferezini De Sá ◽  
Eliane Pereira Da Silva ◽  
...  
Keyword(s):  
Field Tests ◽  
Carbon Dioxide Production ◽  
Cross Sectional Study ◽  
Peak Oxygen Uptake ◽  
Cardiopulmonary Exercise Test ◽  
Rehabilitation Program ◽  
The Body ◽  
University Hospital ◽  
Functional Evaluation ◽  
Cross Sectional

The 6 minute walk test (6MWT) and the incremental shuttle walking test (ISWT) have been used as an alternative to the Cardiopulmonary Exercise Test (CPX) for functional evaluation as well after rehabilitation programs. The objective was to analysis the cardiorespiratory and metabolic demands among the ISWT, 6MWT and CPX in the obese and the contribution of adiposity markers on this response. An observational and cross-sectional study was conducted with fifteen obese (10 women; 39.4+10.1years), performing CPX, 6MWT and ISWT. The subjects were as initial part of a rehabilitation program and bariatric surgery at the University Hospital. Metabolic and ventilatory variables were recorded by a telemetry system during all tests. Peak oxygen uptake-VO2peak was similar between CPX (18.6±4.0ml/kg/min) and ISWT (15.4±2.9ml/kg/min) and different from 6MWT (13.2±2.5ml/kg/min). There was agreement (3.2ml/kg/min; 95%; IC-3.0-9.4) between VO2peak of CPX and ISWT. CPX duration (R2=0.61;p=0.001) was best-fit by waist circumference (WC) and the body adiposity index(BAI) that reduced 4.7% and 3.2% CPX duration respectively. Forced vital capacity-FVC and WC predicts increasing of carbon dioxide production (VCO2) on CPX (R2=0.95;p=0.001) and ISWT (R2=0.67;p=0.001). In conclusion the obese individuals perform the ISWT and CPX test with similar physiological responses. It is suggested that, ISWT could be an alternative to CPX and that metabolic monitoring of ISWT by telemetry can be useful for the clinical assessment of the functional capacity of the obese.

scholarly journals Body mass index status and peripheral airway obstruction in school-age children: a population-based cohort study

Thorax ◽  
2018 ◽  
Vol 73 (6) ◽  
pp. 538-545 ◽  
Author(s):  
Sandra Ekström ◽  
Jenny Hallberg ◽  
Inger Kull ◽  
Jennifer L P Protudjer ◽  
Per Thunqvist ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Lung Function ◽  
Airway Obstruction ◽  
Body Mass ◽  
Overweight And Obesity ◽  
School Age Children ◽  
Childhood And Adolescence ◽  
Small Airways ◽  
Cross Sectional ◽  
The Impact

BackgroundFew large prospective studies have investigated the impact of body mass index (BMI) on lung function during childhood.MethodsUsing data collected between 2002 and 2013, we analysed associations between BMI status and lung function (assessed by spirometry) from 8 to 16 years, as well as cross-sectional associations with small airway function (impulse oscillometry) at 16 years in the BAMSE cohort (n=2889). At 16 years, cross-sectional associations with local and systemic inflammation were investigated by analysing FENO, blood eosinophils and neutrophils.ResultsOverweight and obesity at 8 years were associated with higher FVC, but lower FEV1/FVC ratio at 8 and 16 years. In boys, but not girls, obesity at 8 years was associated with a further reduction in FEV1/FVC between 8 and 16 years. In cross-sectional analyses, overweight and obesity were associated with higher frequency dependence of resistance (R5–20) and larger area under the reactance curve (AX0.5) at 16 years. Increased blood neutrophil counts were seen in overweight and obese girls, but not in boys. No association was found between BMI status and FENO. Persistent, but not transient, overweight/obesity between 8 and 16 years was associated with higher R5–20 and AX0.5 and lower FEV1/FVC (−2.8% (95% CI −4.1 to −1.2) in girls and −2.7% (95% CI −4.4 to −1.1) in boys) at 16 years, compared with persistent normal weight.ConclusionIn childhood and adolescence, overweight and obesity, particularly persistent overweight, were associated with evidence of airway obstruction, including the small airways.

scholarly journals Low-technology exercise test in the preoperative evaluation of lung resection candidates

2016 ◽  
Vol 73 (2) ◽  
Author(s):  
A. Brunelli ◽  
C. Pompili ◽  
M. Salati
Keyword(s):  
Oxygen Consumption ◽  
Exercise Test ◽  
Screening Test ◽  
Lung Resection ◽  
Cardiopulmonary Exercise Test ◽  
Stair Climbing ◽  
Functional Evaluation ◽  
Exercise Tests ◽  
Walking Test ◽  
Cardiopulmonary Exercise

Exercise tests are increasingly used in the preoperative functional evaluation of lung resection candidates. Low-technology exercise tests include six minute walking, shuttle walking and stair climbing. Conflicting evidence has been reported regarding 6 minute walking test. This test should not be used to select patients for lung resection. An incremental shuttle walk test is easier to replicate than 6 minute walking test. Most patients achieving 25 shuttles or 400 m have a maximum oxygen consumption measured at cardiopulmonary exercise test greater than 15 l/Kg/min. Although this test tends to underestimate performance at the lower range compared to peak oxygen consumption it can be used a screening test before lung resection. Excluding patients from operation based on this test alone is however not recommended and a formal cardiopulmonary exercise test should be always used in those walking less than 400 m. Stair climbing has been extensively studied in thoracic surgery. Several studies have found that poor performance in this test is indicative of cardiopulmonary complications and mortality after lung resection. In particular, climbing less than 12 m represents very high risk, whereas climbing more than 22 m is associated with a favourable outcome. Recent guidelines recommend referring all patients climbing lower than 22 m to cardiopulmonary exercise test. Stair climbing can be used as a screening test in cases cardiopulmonary exercise test is not readily available. In general, patients climbing more than 22 m can proceed to surgery without further evaluation.

scholarly journals Assessment of lung function in a large cohort of patients with acromegaly

2017 ◽  
Vol 177 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Sylvère Störmann ◽  
Bodo Gutt ◽  
Josefine Roemmler-Zehrer ◽  
Martin Bidlingmaier ◽  
Rudolf M Huber ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Vital Capacity ◽  
Large Cohort ◽  
Cross Sectional ◽  
Lung Volumes ◽  
Female Patients ◽  
Significant Difference ◽  
Active Acromegaly ◽  
Expiratory Flow

Objective Acromegaly is associated with increased mortality due to respiratory disease. To date, lung function in patients with acromegaly has only been assessed in small studies, with contradicting results. We assessed lung function parameters in a large cohort of patients with acromegaly. Design Lung function of acromegaly patients was prospectively assessed using spirometry, blood gas analysis and body plethysmography. Biochemical indicators of acromegaly were assessed through measurement of growth hormone and IGF-I levels. This study was performed at the endocrinology outpatient clinic of a tertiary referral center in Germany. Methods We prospectively tested lung function of 109 acromegaly patients (53 male, 56 female; aged 24–82 years; 80 with active acromegaly) without severe acute or chronic pulmonary disease. We compared lung volume, air flow, airway resistance and blood gases to normative data. Results Acromegaly patients had greater lung volumes (maximal vital capacity, intra-thoracic gas volume and residual volume: P < 0.001, total lung capacity: P = 0.006) and showed signs of small airway obstruction (reduced maximum expiratory flow when 75% of the forced vital capacity (FVC) has been exhaled: P < 0.001, lesser peak expiratory flow: P = 0.01). There was no significant difference between active and inactive acromegaly. Female patients had significantly altered lung function in terms of subclinical airway obstruction. Conclusions In our cross-sectional analysis of lung function in 109 patients with acromegaly, lung volumes were increased compared to healthy controls. Additionally, female patients showed signs of subclinical airway obstruction. There was no difference between patients with active acromegaly compared with patients biochemically in remission.

scholarly journals Patterns and Distribution of Imaging Findings on HRCT Chest in Various ILD’s: A Cross-Sectional Study

2021 ◽  
pp. 115-126
Author(s):  
Rakib Ahmad Wani ◽  
Riyaz Ahmad Mir ◽  
Mohd Asif Naik ◽  
Aijaz Ahmad Hakeem
Keyword(s):  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Interstitial Lung Diseases ◽  
Common Type ◽  
Imaging Features ◽  
Imaging Findings ◽  
Air Trapping ◽  
Cross Sectional ◽  
Male Predominance ◽  
Histological Characteristics

Background: Interstitial lung diseases present with diverse clinical, radiological and histological characteristics, yet have significant overlapping features. Different ILDs have different outcomes and need correct diagnosis for appropriate management. UIP, NSIP and sarcoidosis are the most common types. Other important types being COP, RB-ILD, HSP and ILD associated with connective disorders. Objective: To identify patterns and distributions of imaging findings on HRCT for accurate diagnosis of type of ILDs. HRCT of known cases of ILD was done and predominant imaging features of ILDs documented. We had 75 patients in our study group with male predominance (58.6%). UIP was the most common type of ILD with honeycombing, septal thickening and bronchiectasis as the predominant imaging features with sparse ground glassing. Sarcoidosis was the second most common type of ILD with mediastinal and hilar LAP, perilymphatic nodules, fibrotic bands, septal thickening and bronchiectasis as predominant imaging findings. NSIP presented with ground glassing, septal thickening, bronchiectasis, and fibrotic bands as predominant features with no or minimal honeycombing. RB-ILD presented with predominant imaging features of peribronchial thickening, centrilobular nodules, air trapping and fibrotic bands in known smokers. COP presented with predominant imaging features of peripheral consolidations and ground glassings, septal thickenings and bronchiectasis. Lung biopsy is god standard but cannot be performed in every patients owing to higher rates of complication. HRCT has assumed importance in diagnosis and management of ILDs and are relatively specific in its diagnosis.

scholarly journals Pulmonary function testing and chest tomography in patients with acromegaly

2013 ◽  
Vol 8 ◽  
Author(s):  
Gustavo Bittencourt Camilo ◽  
Fernando Silva Guimarães ◽  
Débora Pedroza Guedes Silva ◽  
Roberto Mogami ◽  
Leandro Kasuki ◽  
...  
Keyword(s):  
Lung Function ◽  
Whole Body ◽  
Steady Increase ◽  
Small Airways ◽  
High Resolution Computed Tomography ◽  
Alveolar Volume ◽  
Air Trapping ◽  
Cross Sectional ◽  
Gradual Improvement ◽  
Control Subjects

Background: Despite the gradual improvement in treatment procedures and cure rates of acromegaly, a steady increase in the mortality rate due to respiratory disease has been documented in recent decades. In this study, our objectives were to describe the abnormalities in lung structure and function that occur in acromegalic patients and to correlate these changes with hormonal levels. Methods: This cross-sectional study included 20 acromegalic patients and 20 age-and height-matched control subjects, all non-smokers. All subjects underwent spirometry, whole body plethysmography, carbon monoxide diffusing capacity, and respiratory muscle strength. Acromegalic patients also performed high-resolution computed tomography (HRCT). Results: Most patients were female (65%), with a mean age of 52.5 ± 13 years. Acromegalic patients showed lower values of maximum expiratory pressure (55.9 ± 17.1 vs. 103.7 ± 19.2%; p < 0.001) and maximum inspiratory pressure (71.4 ± 27.8 vs. 85.3 ± 24.1%; p = 0.005) compared to control subjects. The values of forced vital capacity (107.1 ± 15.9 vs. 98.9 ± 21.4%; p = 0.028), total lung capacity – TLC (107.3 ± 12.9 vs. 93.7 ± 7.60%; p = 0.002), residual volume (114.1 ± 22.7 vs. 90.0 ± 14.6%; p < 0.001), and airways’ resistance (3.82 vs. 2.31 cmH2O/L/s; p = 0.039) were greater in acromegalic patients than in control subjects. The difference between the TLC measured by plethysmography and the VA (alveolar volume) measured during the DLCO maneuver was higher in acromegalic patients than in control subjects (0.69 ± 0.46 vs. 0.19 ± 0.61 L; p = 0.021). The main findings in HRCT in acromegalic patients were air trapping, airway calcification and bronchiectasis, which were observed in 60%, 40% and 35% of cases, respectively. There was no significant correlation between the levels of growth hormone and insulin-like growth factor I, the lung function and the air trapping. Conclusions: Acromegalic patients show changes consistent with the involvement of the small airways and ventilation inhomogeneity, both in terms of lung function and structure. However, air trapping cannot be explained either by hormone levels or changes in lung function.

Aspergillus and progression of lung disease in children with cystic fibrosis

Thorax ◽  
2018 ◽  
Vol 74 (2) ◽  
pp. 125-131 ◽  
Author(s):  
Sabariah Noor Harun ◽  
Claire E Wainwright ◽  
Keith Grimwood ◽  
Stefanie Hennig
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Bronchoalveolar Lavage ◽  
Lung Disease ◽  
Lung Function Decline ◽  
Air Trapping ◽  
Cross Sectional ◽  
Progression Model ◽  
Non Linear ◽  
The Impact

BackgroundThe impact of Aspergillus on lung disease in young children with cystic fibrosis is uncertain.AimsTo determine if positive respiratory cultures of Aspergillus species are associated with: (1) increased structural lung injury at age 5 years; (2) accelerated lung function decline between ages 5 years and 14 years and (3) to identify explanatory variables.MethodsA cross-sectional analysis of association between Aspergillus positive bronchoalveolar lavage (BAL) cultures and chest high-resolution CT (HRCT) scan findings at age 5 years in subjects from the Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) study was performed. A non-linear mixed-effects disease progression model was developed using FEV1% predicted measurements at age 5 years from the ACFBAL study and at ages 6–14 years for these subjects from the Australian Cystic Fibrosis Data Registry.ResultsPositive Aspergillus BAL cultures at age 5 years were significantly associated with increased HRCT scores for air trapping (OR 5.53, 95% CI 2.35 to 10.82). However, positive Aspergillus cultures were not associated with either FEV1% predicted at age 5 years or FEV1% predicted by age following adjustment for body mass index z-score and hospitalisation secondary to pulmonary exacerbations. Lung function demonstrated a non-linear decline in this population.ConclusionIn children with cystic fibrosis, positive Aspergillus BAL cultures at age 5 years were associated contemporaneously with air trapping but not bronchiectasis. However, no association was observed between positive Aspergillus BAL cultures on FEV1% predicted at age 5 years or with lung function decline between ages 5 years and 14 years.

scholarly journals Dietary Inflammatory Index (DII®) and Lung Function in Adults from Ten European Countries – Evidence from the GA2LEN Follow-Up Survey

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1393-1393 ◽  
Author(s):  
Francisca de Castro Mendes ◽  
Sumaiyya Thawer ◽  
Nitin Shivappa ◽  
James R Hebert ◽  
Peter G J Burney ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Postal Questionnaire ◽  
P Value ◽  
Dietary Inflammatory Index ◽  
Cross Sectional ◽  
Inflammatory Index

Abstract Objectives To investigate the association between Dietary Inflammatory Index (DII®) and lung function in European adults. Methods The study sample was drawn from the Global Allergy and Asthma Network of Excellence (GA2LEN) screening survey, in which 55,000 adults aged 15 to 75 years answered a postal questionnaire on respiratory symptoms. A stratified random sample was obtained for follow-up. A cross-sectional study was conducted in this sample (n = 3241), which included ascertainment of dietary intake and measures of lung function. Participants completed the internationally validated GA2LEN food frequency questionnaire (FFQ), which enquired about usual intake of 245 food items. The dietary inflammatory index (DII®) was derived to ascertain the inflammatory potential of the diet (minimum and maximum reference range −8.87 to 7.98; i.e., the higher the score the more pro-inflammatory the diet). Participants performed post-bronchodilator spirometry, from which forced vital capacity (FVC), the ratio between the forced exhaled volume in 1 second (FEV1) and FVC (FEV1/FVC), FVC below lower limit of normal (FVC &lt; LLN; (restriction)) and FEV1/FVC &lt; LLN (airway obstruction) were calculated. Exposures and lung function outcomes were weighted to obtain estimated population parameters. Potential confounders included age, sex, height, body mass index, smoking status, country, education and employment. Adjusted regressions were used to investigate the associations between DII and respiratory outcomes. Results The mean age of participants was 48 years (SD ± 15.1), and the median DII was −1.53 (IQR difference 3.5). In the fully adjusted models, a one-unit increase in DII score was statistically significantly associated with a lower FEV1/FVC (β-coefficient −0.46, 95% CI −0.80, −0.12; P-value = 0.008) and with airway obstruction (odds ratio [OR] 1.17, 95% CI 1.03, 1.34; P-value = 0.018]. There was no association with the other lung function outcomes. Conclusions A more pro-inflammatory diet was associated with greater airway obstruction amongst European adults. Funding Sources FCM is funded by The Fulbright Commission and by the Fundação para a Ciência e Tecnologia (SFRH/BD/144,563/2019). This work was conducted as part of The GA2LEN Working Group WP1.2 Epi & Clinical Studies. GA2LEN was funded by the EU Framework Programme for Research, contract No FOOD-CT-2004–506,378.

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