TY - JOUR
T1 - Physiological Responses and Prognostic Value of Common Exercise Testing Modalities in Idiopathic Pulmonary Fibrosis
AU - Vainshelboim, Baruch
AU - Myers, Jonathan
AU - Oliveira, Jose
AU - Izhakian, Shimon
AU - Unterman, Avraham
AU - Kramer, Mordechai Reuven
N1 - Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - This pilot study aimed to compare physiological responses between cycle cardiopulmonary exercise tests (CPETs) and 6-min walk tests (6MWTs) and to assess their prognostic value among patients with idiopathic pulmonary fibrosis (IPF). Methods: Thirty-four patients with IPF (68 ± 8 yr) underwent CPETs and 6MWTs and were followed up for 40 mo. Differences, levels of agreement, and relative risks for mortality were analyzed between measured and estimated peak responses for the 2 tests. Results: Compared with the CPET, oxygen uptake (o2), heart rate (HR), and the nadir of SpO2 were lower during the 6MWT, whereas work rate (WR) was higher. Mean differences were as follows: o2 =-1.9 mL/kg/min, 95% CI, -1.1 to -2.7, P <.001; HR =-9 beats/min, 95% CI, -4 to -14, P =.002; SpO2 =-6%, 95% CI, -4 to -7, P <.001; and WR = 9 W/min, 95% CI, 3 to 16, P =.008. Interclass correlations ranged from 0.84 to 0.90 and both tests demonstrated prognostic value for mortality. Conclusions: Significant differences and variation in peak physiological responses were observed between cycle CPETs and 6MWTs in patients with IPF. However, good agreement was evident, suggesting that both tests provide value for clinical and research settings. Future studies should compare the physiological responses between treadmill CPETs and 6MWTs for prognostic utility in IPF.
AB - This pilot study aimed to compare physiological responses between cycle cardiopulmonary exercise tests (CPETs) and 6-min walk tests (6MWTs) and to assess their prognostic value among patients with idiopathic pulmonary fibrosis (IPF). Methods: Thirty-four patients with IPF (68 ± 8 yr) underwent CPETs and 6MWTs and were followed up for 40 mo. Differences, levels of agreement, and relative risks for mortality were analyzed between measured and estimated peak responses for the 2 tests. Results: Compared with the CPET, oxygen uptake (o2), heart rate (HR), and the nadir of SpO2 were lower during the 6MWT, whereas work rate (WR) was higher. Mean differences were as follows: o2 =-1.9 mL/kg/min, 95% CI, -1.1 to -2.7, P <.001; HR =-9 beats/min, 95% CI, -4 to -14, P =.002; SpO2 =-6%, 95% CI, -4 to -7, P <.001; and WR = 9 W/min, 95% CI, 3 to 16, P =.008. Interclass correlations ranged from 0.84 to 0.90 and both tests demonstrated prognostic value for mortality. Conclusions: Significant differences and variation in peak physiological responses were observed between cycle CPETs and 6MWTs in patients with IPF. However, good agreement was evident, suggesting that both tests provide value for clinical and research settings. Future studies should compare the physiological responses between treadmill CPETs and 6MWTs for prognostic utility in IPF.
KW - 6-min walk test
KW - cardiopulmonary exercise test
KW - exercise capacity
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85064993549&partnerID=8YFLogxK
U2 - 10.1097/HCR.0000000000000362
DO - 10.1097/HCR.0000000000000362
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C2 - 31022002
AN - SCOPUS:85064993549
SN - 1932-7501
VL - 39
SP - 193
EP - 198
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 3
ER -