PT  - JOURNAL ARTICLE
AU  - Jean Pastré
AU  - Anne Prévotat
AU  - Catherine Tardif
AU  - Abderrahmane Mammar
AU  - Jean-Marc Perruchini
AU  - Lidwine Wémeau-Stervinou
AU  - Thierry Perez
AU  - Alain Duhamel
AU  - Benoit Wallaert
TI  - Clinical and functional determinants of exercise limitation in adult patients with cystic fibrosis
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4446
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4446.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4446.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Exercise tolerance is reduced in adult patients with cystic fibrosis (CF). The aim of this retrospective analysis was to determine the mechanisms of this limitation.Patients and methodsCardiopulmonary exercise testing (CPET) with peak exercise blood gas was performed in 102 patients (Sex Ratio M/F=0.51) aged 28+/-11 years old (FEV1<50%: 48 patients; FEV1 between 50 and 80%: 22; FEV1>80%: 32). VO2 peak was correlated with clinical, biological and functional parameters.ResultsVO2 peak was decreased (<84%) in 85% of patients (25+/-9 ml/kg or 65+/-21% predicted) and was correlated with Body Mass Index (r = 0.26), CRP (r = -0.34), FEV1 (r = 0.71), FVC (r = 0.69), RV (r = -0.63) and DLCO (r = 0.56). Upon exercise parameters, VO2 peak was correlated with VE/VO2 at ventilatory threshold, peak VD/VT, peak PaO2, PaCO2 and P(A-a)O2, and ventilatory reserve (r= -0.50 respectively, -0.64, 0.54, 0.64, -0.54 and 0.37). In multivariate analysis, FEV1 was the most predictive parameter of VO2 peak impairment, accounting for 48% of VO2 peak alteration. Reduced or absent ventilatory reserve and excessive hyperventilation (VE/VO2 threshold) accounted for respectively 10 and 8% of VO2 peak alteration. Peak VD/VT and P(A-a)O2 explained only 1% each of the VO2 peak value.ConclusionLimiting aerobic capacity in adult patients with cystic fibrosis is correlated with nutritional status, inflammation and lung function. This limitation is largely dependent, not only on FEV1, but also on the importance of ventilatory response to exercise. CPET is useful for a better management of CF patients.