Cardiopulmonary Exercise Testing in Patients With Interstitial Lung Disease.
dyspnea
exercise capacity
hypoxemia
idiopathic pulmonary fibrosis
ventilatory limitation
Journal
Frontiers in physiology
ISSN: 1664-042X
Titre abrégé: Front Physiol
Pays: Switzerland
ID NLM: 101549006
Informations de publication
Date de publication:
2020
2020
Historique:
received:
15
04
2020
accepted:
22
06
2020
entrez:
6
8
2020
pubmed:
6
8
2020
medline:
6
8
2020
Statut:
epublish
Résumé
Interstitial lung disease (ILD) is a heterogeneous group of conditions characterized by fibrosis and/or inflammation of the lung parenchyma. The pathogenesis of ILD consistently results in exertional dyspnea and exercise intolerance. Cardiopulmonary exercise testing (CPET) provides important information concerning the pathophysiology of ILD that can help inform patient management. Despite the purported benefits of CPET, its clinical utility in ILD is not well defined; however, there is a growing body of evidence that provides insight into the potential value of CPET in ILD. Characteristic responses to CPET in patients with ILD include exercise-induced arterial hypoxemia, an exaggerated ventilatory response, a rapid and shallow breathing pattern, critically low inspiratory reserve volume, and elevated sensations of dyspnea and leg discomfort. CPET is used in ILD to determine cause(s) of symptoms such as exertional dyspnea, evaluate functional capacity, inform exercise prescription, and determine the effects of pharmacological and non-pharmacological interventions on exercise capacity and exertional symptoms. However, preliminary evidence suggests that CPET in ILD may also provide valuable prognostic information and can be used to ascertain the degree of exercise-induced pulmonary hypertension. Despite these recent advances, additional research is required to confirm the utility of CPET in patients with ILD. This brief review outlines the clinical utility of CPET in patients with ILD. Typical patterns of response are described and practical issues concerning CPET interpretation in ILD are addressed. Additionally, important unanswered questions relating to the clinical utility of CPET in the assessment, prognostication, and management of patients with ILD are identified.
Identifiants
pubmed: 32754054
doi: 10.3389/fphys.2020.00832
pmc: PMC7365876
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
832Informations de copyright
Copyright © 2020 Molgat-Seon, Schaeffer, Ryerson and Guenette.
Références
Eur Respir J. 2017 May 25;49(5):
pubmed: 28546272
J Appl Physiol (1985). 1998 Jun;84(6):2000-9
pubmed: 9609795
Eur Respir Rev. 2017 Feb 21;26(143):
pubmed: 28223398
Circulation. 2013 Mar 12;127(10):1157-64
pubmed: 23479667
Exp Physiol. 2017 Nov 1;102(11):1535-1547
pubmed: 28841267
Chron Respir Dis. 2016 May;13(2):162-72
pubmed: 26768011
Eur Respir J. 2007 Jan;29(1):185-209
pubmed: 17197484
Chest. 1984 Mar;85(3):301-6
pubmed: 6697784
Rev Port Pneumol. 2014 Mar-Apr;20(2):92-100
pubmed: 24480488
Eur Respir J. 1994 Apr;7(4):643-50
pubmed: 8005243
Respiration. 2013;86(5):407-13
pubmed: 23735701
Chest. 1996 Dec;110(6):1520-5
pubmed: 8989071
J Clin Invest. 1979 Apr;63(4):665-76
pubmed: 438328
Eur Respir J. 2018 Jan 18;51(1):
pubmed: 29348183
Am J Respir Crit Care Med. 2001 Oct 1;164(7):1171-81
pubmed: 11673205
Am Rev Respir Dis. 1991 Feb;143(2):219-25
pubmed: 1990931
Chest. 1999 Nov;116(5):1175-82
pubmed: 10559073
Am J Transplant. 2009 Apr;9(4 Pt 2):942-58
pubmed: 19341417
Respir Med. 2009 Nov;103(11):1713-8
pubmed: 19497725
Respirology. 2018 Apr;23(4):392-398
pubmed: 29193512
Thorax. 1983 Oct;38(10):778-84
pubmed: 6648857
Ann Am Thorac Soc. 2017 Jul;14(Supplement_1):S3-S11
pubmed: 28510504
J Clin Med. 2016 Aug 18;5(8):
pubmed: 27548238
J Appl Physiol (1985). 2011 Mar;110(3):638-45
pubmed: 21183625
Circulation. 1989 Apr;79(4):863-71
pubmed: 2924417
Am J Respir Crit Care Med. 2016 Feb 1;193(3):299-309
pubmed: 26407036
Chest. 2005 Jun;127(6):2028-33
pubmed: 15947316
Am J Respir Crit Care Med. 2007 May 1;175(9):875-80
pubmed: 17255562
Clin Chest Med. 1984 Mar;5(1):189-206
pubmed: 6723241
Chest. 1995 Feb;107(2):323-9
pubmed: 7842755
J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D109-16
pubmed: 24355635
BMC Pulm Med. 2017 Oct 10;17(1):130
pubmed: 29017478
Chest. 1996 Jun;109(6):1566-76
pubmed: 8769513
Heart. 2011 Jan;97(2):112-7
pubmed: 20889989
Chron Respir Dis. 2010;7(2):101-11
pubmed: 20056733
ERJ Open Res. 2019 Apr 01;5(2):
pubmed: 30949489
Eur Respir Rev. 2015 Mar;24(135):102-14
pubmed: 25726561
Lung. 2010 Apr;188(2):115-23
pubmed: 20012639
Am J Respir Crit Care Med. 2003 Nov 1;168(9):1084-90
pubmed: 12917227
Thorax. 1988 Apr;43(4):276-83
pubmed: 3406914
Clin Chest Med. 2019 Jun;40(2):405-420
pubmed: 31078218
Chest. 1980 Dec;78(6):856-65
pubmed: 7449465
Curr Opin Support Palliat Care. 2008 Jun;2(2):100-4
pubmed: 18685404
Eur Respir Rev. 2017 Jan 17;26(143):
pubmed: 28096284
Eur Respir Rev. 2017 Aug 9;26(145):
pubmed: 28794145
Am J Respir Crit Care Med. 2003 Jan 15;167(2):211-77
pubmed: 12524257
Eur Respir J. 1988 Jun;1(6):510-6
pubmed: 3169220
Respir Med. 2017 May;126:59-67
pubmed: 28427551
Respir Med. 2013 Apr;107(4):622-8
pubmed: 23312985
Am J Respir Crit Care Med. 2011 Mar 15;183(6):788-824
pubmed: 21471066
Circulation. 2011 Feb 15;123(6):668-80
pubmed: 21321183
Clin Chest Med. 1994 Jun;15(2):287-303
pubmed: 8088094
Chest. 1994 Jan;105(1):183-9
pubmed: 8275730
J Appl Physiol (1985). 1994 Aug;77(2):963-73
pubmed: 8002554
Am J Respir Crit Care Med. 2005 Aug 1;172(3):268-79
pubmed: 15879420
Eur J Respir Dis. 1986 Jan;68(1):39-49
pubmed: 3948933
Bull Eur Physiopathol Respir. 1981 Jan-Feb;17(1):15-26
pubmed: 7470683
Eur Respir J. 2016 Feb;47(2):429-60
pubmed: 26797036
Clin Chest Med. 2004 Sep;25(3):435-53, v
pubmed: 15331185
Am J Respir Crit Care Med. 2011 May 1;183(9):1231-7
pubmed: 21131468
Am J Respir Crit Care Med. 2011 Mar 1;183(5):573-81
pubmed: 21037016
Thorax. 2008 Sep;63 Suppl 5:v1-58
pubmed: 18757459
Pulm Med. 2013;2013:956081
pubmed: 23476765
J Clin Invest. 1976 Oct;58(4):880-90
pubmed: 965494
Compr Physiol. 2011 Apr;1(2):663-97
pubmed: 23737199
Eur Respir J. 2015 Sep;46(3):738-49
pubmed: 25976688
Respiration. 2004 May-Jun;71(3):209-13
pubmed: 15133338