TY - JOUR T1 - Practicality and clinical utility of cardiopulmonary exercise testing to investigate complex breathlessness in severe asthma JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.2232 VL - 56 IS - suppl 64 SP - 2232 AU - Amanda Vigus AU - Maximillian Thomas AU - Adel Mansur Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/2232.abstract N2 - Background: breathlessness does not always correlate with asthma severity and is often driven by co-existing conditions such as breathing pattern disorder (BPD) or de-conditioning. Cardiopulmonary exercise testing (CPET) may help in elucidating the causes of breathlessness.Aim: to assess the utility of CPET in the management of complex breathlessness in severe asthma.Methods: well characterised severe asthmatics with prominent breathlessness and exercise limitation underwent standard CPET protocol in a tertiary centre.Results: CPET was performed in 16 patients [mean age 43yrs (range 26-60), 9 females, mean BMI 33.4±6.5kg/m2, FEV1 (L) 2.7±1.1, FEV1%-pred 83.9±25.9%, FEV1/FVC ratio 73.8±9.6 (range 55-86), inhaled corticosteroid dose 1.5±0.7mg/day, oral corticosteroid courses per annum 3.6±3, FeNO 48.1±44 ppb, blood eosinophils 0.5±0.6x109/L]. Twelve (75%) patients completed CPET (loaded exercise time 9.7±2.8, peak heart rate 89±12% predicted). The V’O2 at peak was 85±24 %predicted; at anaerobic threshold 53±11 (range 42-70), and the breathing reserve was 15± 31%. Of the 4 cases that did not complete CPET, 2 had BPD. The CPET diagnoses included BPD in 81% and hyperventilation 56%, deconditioning 12.5%, reduced functional capacity due to obesity 6.5%, and ventilation limitation due to underlying lung disease 6.5%. There were no adverse effects post testing. Results altered diagnosis in 62.5% of cases; reinforced diagnosis in 25%; and did not alter diagnosis in 12.5% (normal CPET).Conclusion: CPET was practical to conduct and aided in elucidating the causes of breathlessness in severe asthma, which facilitated appropriate management.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2232.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -