- Email: [email protected]
Cardiopulmonary Responses in Patients With Pulmonary Sarcoidosis Having Exertional Breathlessness
Pulmonary Physiology SESSION TITLE: Pulmonary Physiology SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM
Cardiopulmonary Responses in Patients With Pulmonary Sarcoidosis Having Exertional Breathlessness Mir Ali* Metro Hospital & Heart Institute, Noida, India PURPOSE: Breathlessness is a frequent complaint in Pulmonary Sarcoidosis and may be due to poor respiratory reserve, muscle dysfunction, cardiac involvement and deconditioning. There is tendency to treat such patients with steroids considering sarcoidosis of lungs being the cause of breathlessness. CPET is used clinically to evaluate exercise tolerance and determinants of limitation. We evaluated patients with Pulmonary Sarcoidosis having shortness of breath on exertion by Cardio pulmonary exercise testing.The purpose of this prospective study was to determine the mechanisms responsible for exercise intolerance in pulmonary sarcoidosis
PULMONARY PHYSIOLOGY
METHODS: Twenty-seven patients of Pulmonary Sarcoidosis were recruited from Sarcoid clinic of Metro Centre for Respiratory Diseases after ethical clearance from Metro Ethics Committe. All patients performed incremental symptom limited exercise test on CPET - Cosmed Quark 4 using electronic braked ergoline bike. Statistical analysis of the results was done. RESULTS: Out of 27 patients, 59% were females, means age was 52.5 + 12.5 yrs. Normal VO2 Max > 85% was achieved in 10/27 patients and showed no exercise limitation. While 63% has reduced exercise capacity with mean VO2 max% predicted was 57.94+ 12.25. Anaerobic threshold was achieved in 2/3rd patients, mean being at 42.7 + 14.1% anaerobic threshold was <40% in 8 cases (mean 28.6+ 9.5%). Nearly half of patients who stopped exercise due to breathlessness had achieved normal VO2 max, while other half of patients had ventilatory limitation causing breathlessness to stop exercise. 70% patient’s had poor heart rate recovery and 2/3rd had low oxygen pulse (VO2/HR). Exercise induced hypoxia demonstrated in 26% cases. CONCLUSIONS: Among Pulmonary Sarcoidosis patients having exertional breathlessness, only 40% had normal exercise capacity and another 41% had ventilatory limitation on exercise, rest being limited to due to cardiac, peripheral or multiple causes. CLINICAL IMPLICATIONS: All patients of pulmonary sarcoidosis having breathlessness on exertion need evaluation for cause of breathlessness before considering treatment as lungs are not always the cause of exercise limitation DISCLOSURE: The following authors have nothing to disclose: Mir Ali No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2017.08.1007
Copyright ª 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
972A
[
152#4S CHEST OCTOBER 2017
]
Cardiopulmonary Responses in Patients With Pulmonary Sarcoidosis Having Exertional Breathlessness Mir Ali* Metro Hospital & Heart Institute, Noida, India PURPOSE: Breathlessness is a frequent complaint in Pulmonary Sarcoidosis and may be due to poor respiratory reserve, muscle dysfunction, cardiac involvement and deconditioning. There is tendency to treat such patients with steroids considering sarcoidosis of lungs being the cause of breathlessness. CPET is used clinically to evaluate exercise tolerance and determinants of limitation. We evaluated patients with Pulmonary Sarcoidosis having shortness of breath on exertion by Cardio pulmonary exercise testing.The purpose of this prospective study was to determine the mechanisms responsible for exercise intolerance in pulmonary sarcoidosis
PULMONARY PHYSIOLOGY
METHODS: Twenty-seven patients of Pulmonary Sarcoidosis were recruited from Sarcoid clinic of Metro Centre for Respiratory Diseases after ethical clearance from Metro Ethics Committe. All patients performed incremental symptom limited exercise test on CPET - Cosmed Quark 4 using electronic braked ergoline bike. Statistical analysis of the results was done. RESULTS: Out of 27 patients, 59% were females, means age was 52.5 + 12.5 yrs. Normal VO2 Max > 85% was achieved in 10/27 patients and showed no exercise limitation. While 63% has reduced exercise capacity with mean VO2 max% predicted was 57.94+ 12.25. Anaerobic threshold was achieved in 2/3rd patients, mean being at 42.7 + 14.1% anaerobic threshold was <40% in 8 cases (mean 28.6+ 9.5%). Nearly half of patients who stopped exercise due to breathlessness had achieved normal VO2 max, while other half of patients had ventilatory limitation causing breathlessness to stop exercise. 70% patient’s had poor heart rate recovery and 2/3rd had low oxygen pulse (VO2/HR). Exercise induced hypoxia demonstrated in 26% cases. CONCLUSIONS: Among Pulmonary Sarcoidosis patients having exertional breathlessness, only 40% had normal exercise capacity and another 41% had ventilatory limitation on exercise, rest being limited to due to cardiac, peripheral or multiple causes. CLINICAL IMPLICATIONS: All patients of pulmonary sarcoidosis having breathlessness on exertion need evaluation for cause of breathlessness before considering treatment as lungs are not always the cause of exercise limitation DISCLOSURE: The following authors have nothing to disclose: Mir Ali No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2017.08.1007
Copyright ª 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
972A
[
152#4S CHEST OCTOBER 2017
]