Rafael Alexandre de Oliveira Deucher, Luis Felipe da Fonseca Reis, Jannis Vasileios Papathanasiou, Beatriz Luiza Pinheiro Alves Azevedo, Jéssica Gabriela Messias Oliveira, Matheus Mello da Silva, Rayanne Costa de Sales, Beatriz Pereira Dos Santos, Arthur de Sá Ferreira, Agnaldo José Lopes
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Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO<sub>2peak</sub> obtained by simple sampling technology in women with RA-associated interstitial lung disease (RA-ILD).</p><p><strong>Methods: </strong>This cross-sectional study evaluated 47 women with RA-ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ-DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (Dl<sub>CO</sub> ), nitrogen single-breath washout (N<sub>2</sub> SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™.</p><p><strong>Results: </strong>VO<sub>2peak</sub> was correlated with age (r = -0.550, p < 0.0001), rheumatoid factor (r = -0.443, p = 0.002), anti-cyclic citrullinated peptide antibodies (r = -0.410, p = 0.004), CDAI (r = -0.462, p = 0.001), HAD-DI (r = -0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), Dl<sub>CO</sub> (r = 0.621, p < 0.0001), phase III slope of N<sub>2</sub> SBW (r = -0.647, p < 0.0001), resonance frequency (F<sub>res</sub> , r = -0.717, p < 0.0001), integrated low-frequency reactance (r = -0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = -0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO<sub>2peak</sub> than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, F<sub>res</sub> , Dl<sub>CO</sub> and age explained 61% of the VO<sub>2peak</sub> variability.</p><p><strong>Conclusions: </strong>As assessed by CPET, women with RA-ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. 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Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO<sub>2peak</sub> obtained by simple sampling technology in women with RA-associated interstitial lung disease (RA-ILD).</p><p><strong>Methods: </strong>This cross-sectional study evaluated 47 women with RA-ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ-DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (Dl<sub>CO</sub> ), nitrogen single-breath washout (N<sub>2</sub> SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™.</p><p><strong>Results: </strong>VO<sub>2peak</sub> was correlated with age (r = -0.550, p < 0.0001), rheumatoid factor (r = -0.443, p = 0.002), anti-cyclic citrullinated peptide antibodies (r = -0.410, p = 0.004), CDAI (r = -0.462, p = 0.001), HAD-DI (r = -0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), Dl<sub>CO</sub> (r = 0.621, p < 0.0001), phase III slope of N<sub>2</sub> SBW (r = -0.647, p < 0.0001), resonance frequency (F<sub>res</sub> , r = -0.717, p < 0.0001), integrated low-frequency reactance (r = -0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = -0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO<sub>2peak</sub> than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, F<sub>res</sub> , Dl<sub>CO</sub> and age explained 61% of the VO<sub>2peak</sub> variability.</p><p><strong>Conclusions: </strong>As assessed by CPET, women with RA-ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. 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引用次数: 1
摘要
背景和目的:虽然峰值摄氧量(VO2peak)是临床实践中最重要的测量方法之一，但高昂的成本和时间消耗导致人们寻求更简单的设备和估计心肺适能(eCPF)方程的发展。由于肺部是受类风湿关节炎(RA)影响最严重的部位之一，本研究旨在建立通过简单采样技术获得的类风湿关节炎相关间质性肺病(RA- ild)女性VO2peak的预测方程。方法:本横断面研究评估了47例RA-ILD患者。参与者接受了以下评估:计算机断层扫描(CT);通过临床疾病活动性指数(CDAI)评价疾病活动性;用健康评估问卷残疾指数(HAQ-DI)测量身体机能;肺功能检测，包括肺活量测定、一氧化碳弥散量(DlCO)、氮单呼吸冲洗(N2 SBW)试验和脉冲振荡测定;使用FitMate™进行心肺运动测试(CPET)。结果:VO2peak与年龄相关(r = -0.550, p CO (r = 0.621, p SBW (r = -0.647, p res, r = -0.717)， p 2peak比有限ILD患者(p res, DlCO和年龄解释了61%的VO2peak变异。结论:根据CPET评估，RA-ILD患者的心肺功能降低，这至少可以部分解释为存在小气道疾病、肺气体交换恶化和高龄。这些肺变量与eCPF的关联可能具有重要的临床意义，并支持使用eCPF方程来改善患者的预后。
Estimating cardiopulmonary fitness with a new sampling technology in patients with rheumatoid arthritis-associated interstitial lung disease.
Background and objectives: Although peak oxygen uptake (VO2peak ) is one of the most important measures in clinical practice, the high cost and time consumption have led to the search for simpler devices and the development of the estimating cardiopulmonary fitness (eCPF) equation. Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO2peak obtained by simple sampling technology in women with RA-associated interstitial lung disease (RA-ILD).
Methods: This cross-sectional study evaluated 47 women with RA-ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ-DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (DlCO ), nitrogen single-breath washout (N2 SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™.
Results: VO2peak was correlated with age (r = -0.550, p < 0.0001), rheumatoid factor (r = -0.443, p = 0.002), anti-cyclic citrullinated peptide antibodies (r = -0.410, p = 0.004), CDAI (r = -0.462, p = 0.001), HAD-DI (r = -0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), DlCO (r = 0.621, p < 0.0001), phase III slope of N2 SBW (r = -0.647, p < 0.0001), resonance frequency (Fres , r = -0.717, p < 0.0001), integrated low-frequency reactance (r = -0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = -0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO2peak than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, Fres , DlCO and age explained 61% of the VO2peak variability.
Conclusions: As assessed by CPET, women with RA-ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. These associations of pulmonary variables with eCPF may be clinically important and support the use of the eCPF equation to improve patient outcomes.
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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