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Ventilatory Threshold and Risk of Pulmonary Exacerbations in Cystic Fibrosis
Natália E Campos1, Fernanda M Vendrusculo1, Margarita Pérez-Ruiz2
1Laboratory of Pediatric Physical Activity, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Aerobic fitness, measured by ventilatory threshold variables during cardiopulmonary exercise testing, is linked to exacerbation risk in cystic fibrosis (CF) patients. Lower oxygen consumption at the ventilatory threshold may predict future exacerbations.
Area of Science:
- Cardiopulmonary exercise testing (CPET) and respiratory medicine.
- Clinical assessment of cystic fibrosis (CF).
- Biomarkers for disease prognosis.
Background:
- Pulmonary exacerbations and aerobic fitness significantly impact cystic fibrosis (CF) prognosis.
- The utility of ventilatory threshold data in predicting CF exacerbations remains underexplored.
Purpose of the Study:
- To investigate the association between aerobic fitness, assessed via ventilatory threshold variables from CPET, and the risk of exacerbations in individuals with CF.
Main Methods:
- Retrospective cohort study including subjects aged 6 years and older.
- Collected data over 4 years: lung function, CPET variables, exacerbation history, and antibiotic use.
- Analyzed data using univariate and multivariate regression models.
Main Results:
- Lung function (FEV1, FEF25-75) and aerobic fitness (V̇O2 at VT) were associated with exacerbation risk.
- In multivariate analysis, only V̇O2 at the ventilatory threshold (%max) significantly predicted exacerbation risk (Cox HR 0.92, P = .01).
- Individuals experiencing exacerbations had lower V̇O2 at VT and higher ventilatory equivalents (V̇E/V̇O2, V̇E/V̇CO2) at VT.
Conclusions:
- CPET variables at the ventilatory threshold are associated with exacerbations in CF patients.
- Percentage V̇O2 at the ventilatory threshold shows potential as a complementary marker for monitoring exacerbations in CF.
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