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Exercise testing in patients with cystic fibrosis—importance of ventilatory parameters

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Abstract

Background

Ventilatory parameters obtained during exercise predict survival in several chronic diseases; however, long-term changes in exercise ventilatory parameters in patients with cystic fibrosis (CF) have yet to be examined and potential differences between sexes in CF are unknown.

Purpose

We sought to examine the change in exercise ventilatory parameters over time in patients with CF and determine if the change is different between sexes.

Methods

Exercise capacity (VO2 peak) and exercise ventilatory parameters (VE/VO2 peak, VE/VCO2 peak, and VE/VCO2 slope) were determined from a maximal cardio-pulmonary test on a cycle ergometer on two visits separated by 39 ± 16 months in 20 patients with CF (10 female, 10 male).

Results

No differences between sexes were observed at visit 1 (all p > 0.05). Overall, exercise ventilatory parameters significantly (p < 0.05) deteriorated between visits, with no change (p > 0.05) in VO2 peak. Moreover, compared to males, female patients exhibited greater deteriorations in VE/VO2 peak (p = 0.001), VE/VCO2 peak (p = 0.002), and VE/VCO2 slope (p = 0.016) between visits.

Conclusions

These data in patients with CF indicate that exercise ventilatory parameters decline over time despite no change in VO2 peak, and female patients exhibit a more rapid deterioration compared to males.

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Abbreviations

BMI:

Body mass index

CF:

Cystic fibrosis

CPET:

Cardio-pulmonary exercise test

DXA:

Dual-energy X-ray absorptiometry

FeCO2 :

Fraction of expired CO2

FEV1 :

Forced expiratory volume in 1 s

FFM:

Fat-free mass

FVC:

Forced vital capacity

MVV:

Maximum voluntary ventilation

PaCO2 :

Partial pressure of arterial CO2

RR:

Respiratory rate

VCO2 :

Volume of carbon dioxide output

V D/V T :

Dead space-to-tidal volume ratio

V E :

Minute ventilation

VO2 :

Volume of oxygen consumption

V T :

Tidal volume

VT:

Ventilatory threshold

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Funding

Supported in part by a Vertex Pharmaceuticals Incorporated IIS Grant and NIH/NIDDK R21DK100783 (R.A.H.).

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Authors and Affiliations

  1. Georgia Prevention Institute, Augusta University, 1120 15th Street, HS-1725, Augusta, GA, 30912, USA

    Matthew A. Tucker, Nichole Lee, Paula Rodriguez-Miguelez, Jacob Looney, Reva H. Crandall & Ryan A. Harris

  2. Pediatric Pulmonology, Augusta University, Augusta, GA, USA

    Reva H. Crandall & Kathleen T. McKie

  3. Pulmonary and Critical Care Medicine, Augusta University, Augusta, GA, USA

    Caralee Forseen

  4. Sport and Exercise Sciences Research Institute, Ulster University, Jordanstown, Northern Ireland, UK

    Ryan A. Harris

Authors
  1. Matthew A. Tucker
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  2. Nichole Lee
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  3. Paula Rodriguez-Miguelez
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  4. Jacob Looney
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  5. Reva H. Crandall
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  6. Caralee Forseen
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  7. Kathleen T. McKie
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  8. Ryan A. Harris
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Contributions

MAT and RAH conceived the study; MAT, NS, PRM, JL, RHC, CF, and KTM recruited patients and collected data; MAT and RAH analyzed and interpreted data and drafted the manuscript. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All persons designated as authors qualify for authorship, and all those who qualify for authorship are listed.

Corresponding author

Correspondence to Ryan A. Harris.

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None to declare.

Additional information

Communicated by Susan Hopkins.

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Tucker, M.A., Lee, N., Rodriguez-Miguelez, P. et al. Exercise testing in patients with cystic fibrosis—importance of ventilatory parameters. Eur J Appl Physiol 119, 227–234 (2019). https://doi.org/10.1007/s00421-018-4018-5

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  • DOI: https://doi.org/10.1007/s00421-018-4018-5

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