Cardiopulmonary Exercise Testing Provides Prognostic Information in Advanced Cystic Fibrosis Lung Disease

被引：1

作者：

Radtke, Thomas ^{[1
]}

Urquhart, Don S. ^{[3
]}

Braun, Julia ^{[1
]}

Barry, Peter J. ^{[4
]}

Waller, Ian ^{[4
]}

Petch, Nicole ^{[4
]}

Mei-Zahav, Meir ^{[5
,6
,7
]}

Kramer, Mordechai R. ^{[5
,6
,7
]}

Hua-Huy, Thong ^{[8
]}

Dinh-Xuan, Anh Tuan ^{[8
]}

Innes, J. Alastair ^{[9
]}

McArthur, Sara ^{[10
]}

Sovtic, Aleksandar ^{[11
]}

Gojsina, Bojana ^{[11
]}

Verges, Samuel ^{[12
]}

De Maat, Tanguy ^{[12
]}

Morrison, Lisa ^{[13
]}

Wood, Jamie ^{[14
,15
]}

Crute, Samantha ^{[15
]}

Williams, Craig A. ^{[16
]}

Tomlinson, Owen W. ^{[17
]}

Bar-Yoseph, Ronen ^{[18
]}

Hebestreit, Alexandra ^{[19
]}

Quon, Bradley S. ^{[20
,21
]}

Kwong, Eugenie ^{[20
,21
]}

Saynor, Zoe L. ^{[22
,23
]}

Causer, Adam J. ^{[23
]}

Stephenson, Anne L. ^{[24
]}

Schneiderman, Jane E. ^{[25
,26
]}

Shaw, Michelle ^{[27
]}

Dwyer, Tiffany ^{[28
,29
]}

Stevens, Daniel ^{[30
]}

Remus, Natascha ^{[31
]}

Douvry, Benoit ^{[31
]}

Foster, Karla ^{[32
]}

Benden, Christian ^{[2
]}

Ratjen, Felix ^{[25
]}

Hebestreit, Helge ^{[19
]}

机构：

[1] Univ Zurich, Div Chron Dis Epidemiol, Epidemiol Biostat & Prevent Inst, Zurich, Switzerland

[2] Univ Zurich, Fac Med, Zurich, Switzerland

[3] Royal Hosp Children & Young People, Dept Paediat Resp & Sleep Med, Edinburgh, Scotland

[4] Wythenshawe Hosp, Manchester Univ NHS Fdn Trust, Manchester Adult Cyst Fibrosis Ctr, Manchester, England

[5] Schneider Childrens Med Ctr Israel, Pulm Inst, Petah Tiqwa, Israel

[6] Beilinson Med Ctr, Rabin Med Ctr, Petah Tiqwa, Israel

[7] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel

[8] Univ Paris 05, Hop Cochin, AP HP, Serv Physiol Explorat Fonct, Paris, France

[9] Western Gen Hosp, Scottish Adult Cyst Fibrosis Serv, Edinburgh, Scotland

[10] NHS Lothian, Resp Physiol Serv, Edinburgh, Scotland

[11] Univ Belgrade, Mother & Child Hlth Inst, Fac Med, Belgrade, Serbia

[12] Univ Grenoble Alpes, HP2 Lab, INSERM, CHU Grenoble Alpes, Grenoble, France

[13] Queen Elizabeth Univ Hosp, West Scotland Adult Cyst Fibrosis Unit, Glasgow, Scotland

[14] Icahn Sch Med Mt Sinai, Rehabil & Human Performance, New York, NY USA

[15] Sir Charles Gairdner Hosp, Physiotherapy Dept, Perth, WA, Australia

[16] Univ Exeter, Dept Publ Hlth & Sports Sci, Childrens Hlth & Exercise Res Ctr, Exeter, England

[17] Royal Devon Univ Healthcare NHS Trust, Exeter, England

[18] Rambam Hlth Care Campus, Rappaport Childrens Hosp, Pediat Pulm Inst, Haifa, Israel

[19] Univ Hosp Wuerzburg, Univ Childrens Hosp Wuerzburg, Wurzburg, Germany

[20] St Pauls Hosp, Adult Cyst Fibrosis Program, Vancouver, BC, Canada

[21] St Pauls Hosp, Ctr Hlth Lung Innovat, Vancouver, BC, Canada

[22] Univ Portsmouth, Sch Sport Hlth & Exercise Sci, Fac Sci & Hlth, Portsmouth, England

[23] Univ Hosp Southampton NHS Fdn Trust, Cyst Fibrosis Unit, Southampton, England

[24] St Michaels Hosp, Adult Cyst Fibrosis Ctr, Toronto, ON, Canada

[25] Hosp Sick Children, Div Resp Med, Toronto, ON, Canada

[26] Univ Toronto, Hosp Sick Children, Kinesiol & Phys Educ, Toronto, ON, Canada

[27] Univ Toronto, Hosp Sick Children, Div Translat Med, Toronto, ON, Canada

[28] Univ Sydney, Sydney Sch Hlth Sci, Fac Med & Hlth, Discipline Physiotherapy, Sydney, NSW, Australia

[29] Royal Prince Alfred Hosp, Dept Resp Med, Sydney, NSW, Australia

[30] Dalhousie Univ, Sch Hlth & Human Performance, Div Kinesiol, Halifax, NS, Canada

[31] Univ Paris Est, Ctr Intercommunal Creteil, Serv Pneumol, INSERM, Creteil, France

[32] Cincinnati Childrens Hosp Med Ctr, Pulm Med, Cincinnati, OH USA

来源：

ANNALS OF THE AMERICAN THORACIC SOCIETY | 2024年 / 21卷 / 03期

关键词：

CF; lung transplantation; peak work rate; peak oxygen uptake; survival; CFTR GENOTYPE; WALK TEST; PREDICTOR; MORTALITY; SOCIETY;

D O I：

10.1513/AnnalsATS.202304-317OC

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Rationale: Cardiopulmonary exercise testing (CPET) provides prognostic information in cystic fibrosis (CF); however, its prognostic value for patients with advanced CF lung disease is unknown. Objectives: To determine the prognostic value of CPET on the risk of death or lung transplant (LTX) within 2 years. Methods: We retrospectively collected data from 20 CF centers in Asia, Australia, Europe, and North America on patients with a forced expiratory volume in 1 second (FEV1) <= 40% predicted who performed a cycle ergometer CPET between January 2008 and December 2017. Time to death/LTX was analyzed using mixed Cox proportional hazards regression. Conditional inference trees were modeled to identify subgroups with increased risk of death/LTX. Results: In total, 174 patients (FEV1, 30.9% 65.8% predicted) were included. Forty-four patients (25.5%) died or underwent LTX. Cox regression analysis adjusted for age, sex, and FEV1 revealed percentage predicted peak oxygen uptake (<(V)over dot>O-2peak) and peak work rate (W-peak) as significant predictors of death/LTX: adjusted hazard ratios per each additional 10% predicted were 0.60 (95% confidence interval, 0.43-0.90; P= 0.008) and 0.60 (0.48-0.82; P, 0.001). Tree-structured regression models, including a set of 11 prognostic factors for survival, identified W-peak to be most strongly associated with 2-year risk of death/LTX. Probability of death/LTX was 45.2% for those with a W-peak < 49.2% predicted versus 10.9% for those with a W-peak > 49.2% predicted (P, 0.001). Conclusions: CPET provides prognostic information in advanced CF lung disease, and W-peak appears to be a promising marker for LTX referral and candidate selection.

引用

页码：411 / 420

页数：10

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