PT  - JOURNAL ARTICLE
AU  - Luiz Felipe Frohlich
AU  - Danilo C. Berton
AU  - Paulo J.C. Vieira
AU  - Jorge P. Ribeiro
AU  - Paulo J.Z. Teixeira
AU  - Fernando A.A. Silva
TI  - Exercise capacity and limiting factors in older patients with post infectious bronchiolitis obliterans
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4440
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4440.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4440.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Exercise capacity has been poorly studied in patients with post-infectious bronchiolitis obliterans (PBO) and main studies evaluated children with follow-up in older subjects lacking.We evaluated exercise capacity in older patients with PBO and mechanisms of exercise limitation.This was a cross-sectional study including the oldest patients of our tertiary care center. Cycle incremental cardiopulmonary exercise tests with investigation of dynamic hyperinflation and exercise induced bronchoconstriction (EIB) were performed.Sixteen patients were studied with a mean age of 15.3±3.9 (range 10-23) years, and post-bronchodilator (BD) resting lung function (%pred): FVC 88.9±19.3; FEV1 67.4±27.5, TLC 115.3±10.7; RV 234.3±87.1, DLCO 73.6±11.9. Only 7 patients (43.8%) had reduced exercise capacity (VO2peak<84%pred), of these 5 (71.4%) was <16 years-old. VO2peak was only correlated with age (r=0.58; p=0.01) and DLCO% pred (r=0.66; p=0.01).Patients with reduced exercise capacity tended to be younger (13.4±3.3 vs 16.8±3.9 years; p=0.09), with greater FEV1 response to BD (18.9±12.8 vs 7.0±11.9 %; p=0.08) and lower DLCO (67.8±12.9 vs 81.2±9.2%; p=0.053). No difference were found in relation to ventilatory reserve and dynamic hyperinflation during exercise. Of the 4 patients who presented EIB, 3 (75%) had reduced exercise capacity. Nevertheless, FEV1 alteration post-exercise was not significantly different from those with preserved exercise capacity (-17.0±20.3 vs -5.7±6.7%, p=0.20).In conclusion, it seems that functional alterations of POB tend to ameliorate with aging. Those with reduced exercise capacity present lower lung diffusion capacity and greater airway obstruction variability.