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Spiroergometric parameters at maximal exercise testing assessed functional respiratory impairment in asbestos‐induced fibrosis
Author(s) -
Schneider Joachim,
Arhelger Rolf,
Funk Melanie
Publication year - 2014
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12055
Subject(s) - asbestosis , medicine , oxygen pulse , respiratory system , vo2 max , cardiology , physical therapy , heart rate , lung , blood pressure
Exercise intolerance is typical for asbestosis. We examined the correlation of spiroergometric parameters with severity of asbestosis according to the International Labour Office ( ILO ) classification. Patients were compared to a healthy control group. Objectives Nineteen consecutive male patients with compensated asbestosis and 24 healthy subjects were examined. Methods All participants underwent pulmonary functional testing including maximal cardiopulmonary exercise testing ( CPET ). Results were compared to those of healthy subjects; the correlation to disease status was investigated. Results Significantly lower VC in , FVC , FEV 1 , MEF 50 , TLC and PaO 2 at rest ( P  < 0.001) were observed in asbestosis patients. Lower peak (weight‐related) work rate ( WR , WR /kg), (weight‐related) oxygen uptake ( V′O 2 , V′O 2 /kg), oxygen pulse ( V′O 2 /hr), ventilation volume ( V ′ E ), carbon dioxide output ( V′CO 2 ) and blood lactate was associated ( P  < 0.001) with more severe asbestosis according to the ILO ‐classification. Significant positive correlations ( P  < 0.001) were seen for alveolar‐arterial oxygen difference [ P(A‐a)O 2 ] and PaCO 2 . Multiple regression analysis revealed that asbestosis was the only significant factor associated with the spiroergometric parameters ( P  < 0.001). A reduction of V′O 2 , V′O 2 /kg, V′O 2 /hr, V ′ E , or V′CO 2 at identical submaximal workload could neither be detected among the asbestosis severity nor in comparison to healthy subjects. Only the respiratory frequency was depending on severity of asbestosis. Conclusions The severity of asbestosis correlates with maximal WR , V′O 2 , V′O 2 /hr, V ′ E and gas exchange. At identical workload the discrimination between patients and controls was only possible concerning the respiratory frequency. For detection of limitations in asbestosis patients, maximal CPET is recommended.

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