Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis
Background: Lung function deterioration in cystic fibrosis (CF) is typically measured by a decline in the forced expiratory volume in one second (FEV<sub>1</sub>%), which is thought to be a late marker of lung disease. Dynamic hyperinflation (DH) is seen in obstructive lung diseases whil...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/18/5834 |
| _version_ | 1797579509259567104 |
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| author | Einat Shmueli Yulia Gendler Patrick Stafler Hagit Levine Guy Steuer Ophir Bar-On Hannah Blau Dario Prais Meir Mei-Zahav |
| author_facet | Einat Shmueli Yulia Gendler Patrick Stafler Hagit Levine Guy Steuer Ophir Bar-On Hannah Blau Dario Prais Meir Mei-Zahav |
| author_sort | Einat Shmueli |
| collection | DOAJ |
| description | Background: Lung function deterioration in cystic fibrosis (CF) is typically measured by a decline in the forced expiratory volume in one second (FEV<sub>1</sub>%), which is thought to be a late marker of lung disease. Dynamic hyperinflation (DH) is seen in obstructive lung diseases while exercising. Our aim was to assess whether DH could predict pulmonary deterioration in CF; a secondary measure was the peak VO<sub>2</sub>. Methods: A retrospective study was conducted of people with CF who performed cardiopulmonary exercise tests (CPETs) during 2012–2018. The tests were classified as those demonstrating DH non-DH. Demographic, genetic, and clinical data until 12.2022 were extracted from patient charts. Results: A total of 33 patients aged 10–61 years performed 41 valid CPETs with valid DH measurements; sixteen (39%) demonstrated DH. At the time of the CPETs, there was no difference in the FEV<sub>1</sub>% measurements between the DH and non-DH groups (median 83.5% vs. 87.6%, respectively; <i>p</i> = 0.174). The FEV<sub>1</sub>% trend over 4 years showed a decline in the DH group compared to the non-DH group (<i>p</i> = 0.009). A correlation was found between DH and the lung clearance index (LCI), as well as the FEV<sub>1</sub>% (r = 0.36 and <i>p</i> = 0.019 and r = −0.55 and <i>p</i> = 0.004, respectively). Intravenous (IV) antibiotic courses during the 4 years after the CPETs were significantly more frequent in the DH group (<i>p</i> = 0.046). The peak VO<sub>2</sub> also correlated with the FEV<sub>1</sub>% and LCI (r = 0.36 and <i>p</i> = 0.02 and r = −0.46 and <i>p</i> = 0.014, respectively) as well as with the IV antibiotic courses (r = −0.46 and <i>p</i> = 0.014). Conclusions: In our cohort, the DH and peak VO<sub>2</sub> were both associated with lung function deterioration and more frequent pulmonary exacerbations. DH may serve as a marker to predict pulmonary deterioration in people with CF. |
| first_indexed | 2024-03-10T22:37:12Z |
| format | Article |
| id | doaj.art-65c6120bf054487e9e7333b29f7a4136 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T22:37:12Z |
| publishDate | 2023-09-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-65c6120bf054487e9e7333b29f7a41362023-11-19T11:18:01ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011218583410.3390/jcm12185834Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic FibrosisEinat Shmueli0Yulia Gendler1Patrick Stafler2Hagit Levine3Guy Steuer4Ophir Bar-On5Hannah Blau6Dario Prais7Meir Mei-Zahav8Graub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelDepartment of Nursing, School of Health Sciences, Ariel University, Ariel 40700, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelGraub Cystic Fibrosis Center, Pulmonary Institute, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, Petah Tiqwa 49202, IsraelBackground: Lung function deterioration in cystic fibrosis (CF) is typically measured by a decline in the forced expiratory volume in one second (FEV<sub>1</sub>%), which is thought to be a late marker of lung disease. Dynamic hyperinflation (DH) is seen in obstructive lung diseases while exercising. Our aim was to assess whether DH could predict pulmonary deterioration in CF; a secondary measure was the peak VO<sub>2</sub>. Methods: A retrospective study was conducted of people with CF who performed cardiopulmonary exercise tests (CPETs) during 2012–2018. The tests were classified as those demonstrating DH non-DH. Demographic, genetic, and clinical data until 12.2022 were extracted from patient charts. Results: A total of 33 patients aged 10–61 years performed 41 valid CPETs with valid DH measurements; sixteen (39%) demonstrated DH. At the time of the CPETs, there was no difference in the FEV<sub>1</sub>% measurements between the DH and non-DH groups (median 83.5% vs. 87.6%, respectively; <i>p</i> = 0.174). The FEV<sub>1</sub>% trend over 4 years showed a decline in the DH group compared to the non-DH group (<i>p</i> = 0.009). A correlation was found between DH and the lung clearance index (LCI), as well as the FEV<sub>1</sub>% (r = 0.36 and <i>p</i> = 0.019 and r = −0.55 and <i>p</i> = 0.004, respectively). Intravenous (IV) antibiotic courses during the 4 years after the CPETs were significantly more frequent in the DH group (<i>p</i> = 0.046). The peak VO<sub>2</sub> also correlated with the FEV<sub>1</sub>% and LCI (r = 0.36 and <i>p</i> = 0.02 and r = −0.46 and <i>p</i> = 0.014, respectively) as well as with the IV antibiotic courses (r = −0.46 and <i>p</i> = 0.014). Conclusions: In our cohort, the DH and peak VO<sub>2</sub> were both associated with lung function deterioration and more frequent pulmonary exacerbations. DH may serve as a marker to predict pulmonary deterioration in people with CF.https://www.mdpi.com/2077-0383/12/18/5834cystic fibrosiscardiopulmonary exercise testpulmonary functiondynamic hyperinflation |
| spellingShingle | Einat Shmueli Yulia Gendler Patrick Stafler Hagit Levine Guy Steuer Ophir Bar-On Hannah Blau Dario Prais Meir Mei-Zahav Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis Journal of Clinical Medicine cystic fibrosis cardiopulmonary exercise test pulmonary function dynamic hyperinflation |
| title | Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis |
| title_full | Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis |
| title_fullStr | Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis |
| title_full_unstemmed | Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis |
| title_short | Dynamic Hyperinflation While Exercising—A Potential Predictor of Pulmonary Deterioration in Cystic Fibrosis |
| title_sort | dynamic hyperinflation while exercising a potential predictor of pulmonary deterioration in cystic fibrosis |
| topic | cystic fibrosis cardiopulmonary exercise test pulmonary function dynamic hyperinflation |
| url | https://www.mdpi.com/2077-0383/12/18/5834 |
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