The prognostic value of cardiopulmonary exercise testing in idiopathic pulmonary fibrosis.
BACKGROUND
Idiopathic pulmonary fibrosis (IPF) is characterized by progressive dyspnea, impaired gas exchange, and ultimate mortality.


OBJECTIVE
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.


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.
Fell
Charlene D
CD
Division of Respiratory Medicine, University of Calgary, Calgary, Canada.
Liu
Lyrica Xiaohong
LX
Motika
Caroline
C
Kazerooni
Ella A
EA
Gross
Barry H
BH
Travis
William D
WD
Colby
Thomas V
TV
Murray
Susan
S
Toews
Galen B
GB
Martinez
Fernando J
FJ
Flaherty
Kevin R
KR
D000368:Aged; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011658:Pulmonary Fibrosis / Q000175:diagnosis* / Q000378:metabolism*; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects
D010100:Oxygen