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* From the Adult Cystic Fibrosis Outpatient Clinic (Drs. Pouliou, Papamichalopoulos, and Perpati), Athens Chest Hospital; Department of Pulmonary and Critical Care Medicine (Drs. Nanas, Kyprianou, Mavrou, and Roussos), National and Kapodestrian University, Athens, Greece.
Correspondence to: Eleni Pouliou, MD, Pulmonary and Critical Care Medicine, National and Kapodestrian University, Evgenidio Hospital, Papadiamantopoulou 20, 11528 Athens, Greece; e-mail: snanas{at}cc.uoa.gr
Study objectives: To explore the significance of oxygen kinetics during early recovery after maximal cardiopulmonary exercise testing (CPET) in the assessment of functional capacity and severity of the disease in cystic fibrosis (CF) patients.
Participants: Eighteen patients with CF (9 male/9 female;
mean ± SD age, 23 ± 13 years) and 11 healthy subjects (3 male/8
female; mean age, 29 ± 4 years) underwent maximum CPET on a
treadmill. Breath-by-breath analysis was used for measuring oxygen
consumption (
O2), carbon dioxide
production, and ventilation. Maximum
O2
(
O2peak) and the first-degree slope of
O2 decline during early recovery
(
O2/t-slope) were calculated. To assess
the severity of the disease, we used standard indexes like
FEV1 (% predicted),
O2peak,
and a widely accepted system of clinical evaluation, the Schwachman
score (SS).
Results:
O2/t-slope was significantly lower in CF
patients compared to healthy subjects (0.61 ± 0.31 L/min/min vs
1.1 ± 0.13 L/min/min; p < 0.01) and was closely correlated to
FEV1(r = 0.90, p < 0.001),
O2peak (r = 0.81,
p < 0.001), and the SS (r = 0.81, p < 0.001).
The multivariate analysis showed that the only independent predictor of
the SS is the
O2/t-slope.
Conclusion: We conclude that in CF patients, the prolonged oxygen kinetics during early recovery from maximal exercise is related to the disease severity.
Key Words: cystic fibrosis exercise recovery Schwachman score
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