[Prognostic value of clinical exercise testing in adult patients with cystic fibrosis].
BACKGROUND
Current guidelines for referring cystic fibrosis (CF) patients for lung transplantation, based on resting parameters, are insufficient to predict 3-year mortality. The aim of this study was to determine the prognostic value of cardiopulmonary exercise testing (CPET) in adult CF patients.


METHODS
A multicenter retrospective study on 3-year outcomes was made on 51 adult CF patients who underwent CPET with blood gas analysis. Demographic data, resting pulmonary function and CPET parameters were collected to perform a univariate survival analysis by Kaplan-Meier curves and log-rank tests. To estimate prognosis, a multivariate logistic regression analysis was performed.


RESULTS
The survival log-rank analysis indicated that lower FEV(1), lower body mass index (BMI), diabetes mellitus, lower work rate and higher alveolar-arterial gradient for oxygen (P[A-a]O(2)) at peak exercise were associated with a significantly higher risk of death. The logistic regression analysis showed that BMI (<19.8) and P(A-a)O(2) peak (>43 mmHg) were independently associated with a lower chance of survival.


CONCLUSIONS
CPET with blood gas analysis may have a prognostic value in adult CF patients. Further larger prospective clinical studies are warranted to confirm these preliminary results.
Nguyen
S
S
Service de pneumologie et immunoallergologie, centre de ressources et de compétence pour la mucoviscidose adulte, clinique des maladies respiratoires, hôpital Albert-Calmette, CHRU de Lille, 59037 Lille cedex, France.
Leroy
S
S
Cracowski
C
C
Perez
T
T
Valette
M
M
Neviere
R
R
Aguilaniu
B
B
Wallaert
B
B
D000328:Adult; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000401:mortality; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate