The prognostic value of cardiopulmonary exercise testing in idiopathic pulmonary fibrosis

Am J Respir Crit Care Med. 2009 Mar 1;179(5):402-7. doi: 10.1164/rccm.200802-241OC. Epub 2008 Dec 12.

Abstract

Rationale: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive dyspnea, impaired gas exchange, and ultimate mortality.

Objectives: To test the hypothesis that maximal oxygen uptake during cardiopulmonary exercise testing at baseline and with short-term longitudinal measures would predict mortality in patients with idiopathic pulmonary fibrosis.

Methods: Data from 117 patients with IPF and longitudinal cardiopulmonary exercise tests were examined retrospectively. Survival was calculated from the date of the first cardiopulmonary exercise test.

Measurements and main results: Patients with baseline maximal oxygen uptake less than 8.3 ml/kg/min had an increased risk of death (n = 8; hazard ratio, 3.24; 95% confidence interval, 1.10-9.56; P = 0.03) after adjusting for age, gender, smoking status, baseline forced vital capacity, and baseline diffusion capacity for carbon monoxide. We were unable to define a unit change in maximal oxygen uptake that predicted survival in our cohort.

Conclusions: We conclude that a threshold maximal oxygen uptake of 8.3 ml/kg/min during cardiopulmonary exercise testing at baseline adds prognostic information for patients with IPF.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Exercise Test*
  • Exercise Tolerance
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Oxygen / metabolism
  • Oxygen Consumption / physiology
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Pulmonary Fibrosis / diagnosis*
  • Pulmonary Fibrosis / metabolism*
  • Retrospective Studies
  • Smoking / adverse effects

Substances

  • Oxygen