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Exercise Performance and Dynamic Hyperinflation in Lymphangioleiomyomatosis.
MedLine Citation:
PMID:  22700863     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
RATIONALE: Lymphangioleiomyomatosis (LAM) is characterized by exercise performance impairment. Although airflow limitation is common, no previous studies have evaluated the prevalence and impact of dynamic hyperinflation (DH) in LAM. OBJECTIVES: To investigate the dynamic responses during maximal exercise and the prevalence, predictors and repercussions of DH in LAM. METHODS: Forty-two LAM patients performed symptom-limited incremental cycle exercise and pulmonary functions tests (PFTs) and were compared to ten age-matched healthy women. Dyspnea intensity, inspiratory capacity, oxygen saturation (SpO2) and cardiac, metabolic and respiratory variables were assessed during exercise. LAM patients also performed a six-minute walk test (6MWT). MAIN RESULTS: LAM patients had higher baseline dyspnea, poorer quality of life, obstructive pattern, air trapping and reduced DLCO in PFTs. Although they had the same level of regular physical activity, their maximal exercise performance was reduced and was associated with ventilatory limitation, greater desaturation and dyspnea. The prevalence of DH was high in LAM (55%), even in patients with mild spirometric abnormalities, and was correlated with airflow obstruction, air trapping and DLCO. Compared with the non-DH subgroup, the patients who developed DH had a ventilatory limitation contributing to exercise cessation on cycling and higher desaturation and dyspnea intensity during the 6MWT. CONCLUSIONS: Ventilatory limitation and gas exchange impairment are important causes of exercise limitation in LAM. DH is frequent in LAM, even in patients with mild spirometric abnormalities. DH was associated with the severity of disease, higher dyspnea and lower SpO2. In the 6MWT, desaturation and dyspnea were greater in patients with DH.
Authors:
Bruno G Baldi; André L P Albuquerque; Suzana P Pimenta; João M Salge; Ronaldo A Kairalla; Carlos R R Carvalho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-14
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  -     ISSN:  1535-4970     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.
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