Exercise responses are related to structural lung damage in CF pulmonary disease

Summary Introduction Early detection of lung disease is a primary objective in monitoring patients with Cystic Fibrosis (CF); High‐Resolution‐Computed‐Tomography (HRCT) assesses structural damage. Spirometry and cardiopulmonary exercise testing are used for functional evaluation of CF lung disease. Aim To evaluate the deterioration of exercise testing parameters over a 2‐year period compared to the change of spirometry and HRCT parameters among CF patients. Methods Twenty‐eight CF patients were evaluated with HRCT, spirometry, and exercise testing; 15 had two assessments with an interval of 2 years. Correlation analyses between Bhalla score parameters and functional measures were performed. Results Twenty‐eight patients with CF (mean age 14.9 years, mean forced expiratory volume in 1 sec [FEV 1 ] 83.2%) were evaluated. FEV 1 was not found to change significantly in the 2‐year period ( P  = 0.612). Both mean Bhalla score and mean peak oxygen consumption (VO 2 peak %) deteriorated significantly ( P  = 0.014 and P  = 0.026, respectively). VO 2 peak and respiratory equivalents for O 2 and CO 2 at peak exercise were found to be significant predictors of Bhalla score (r = −0.477, P  = 0.010; r = 0.461, P  = 0.018; r = 0.402; P  = 0.042, respectively). Anaerobic threshold was associated with changes in Bhalla score over the following 2 years. Conclusions Exercise testing is more sensitive than spirometry to detect structural changes in CF lungs. Pediatr Pulmonol. 2016; 51:914–920 . © 2016 Wiley Periodicals, Inc.