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Abnormal submaximal cardiopulmonary exercise parameters predict impaired peak exercise performance in sickle cell anemia patients.
- Source :
-
Pediatric blood & cancer [Pediatr Blood Cancer] 2019 Jun; Vol. 66 (6), pp. e27703. Date of Electronic Publication: 2019 Mar 07. - Publication Year :
- 2019
-
Abstract
- Purpose: Sickle cell anemia (SCA) patients frequently have many comorbidities, including diastolic dysfunction (DD) and exercise intolerance. SCA patients often cannot reach maximal effort on exercise testing; little is known regarding whether submaximal exercise parameters can predict abnormal maximal exercise results in SCA patients and if there are any possible associations with DD.<br />Methods: A prospective longitudinal study was performed in SCA patients. All patients had a resting cardiac MRI (CMR), cardiopulmonary exercise test (CPET) with cycle ergometry using a ramp protocol, and an echocardiogram. Exercise data were compared with age-, gender-, and size-matched normal controls.<br />Results: Compared with normal controls, the SCA group (n = 19) had lower mean max oxygen consumption (VO <subscript>2</subscript> ; 1378 ± 412 mL/min vs 2237 ± 580, P < 0.01) and workload (117 ± 37.6 watts vs 175 ± 50.5 watts, P = 0.0003). When evaluating the submaximal exercise parameters, there was lower VO <subscript>2</subscript> at the anaerobic threshold (AT; 950 ± 311.7 vs 1460 ± 409.9, P < 0.01) and oxygen uptake efficiency slope (OUES) at AT (1512 ± 426.2 vs 2080 ± 339, P < 0.01). The max VO <subscript>2</subscript> strongly correlated with VO <subscript>2</subscript> at AT (r = 0.9, P < 0.01) and OUES (r = 0.83, P < 0.01) at AT. The VO <subscript>2</subscript> at AT correlated with hematocrit (r = 0.77, P < 0.05). The OUES correlated with left ventricular ejection fraction by CMR (r = 0.55, P = 0.01), hematocrit (r = 0.52, P = 0.02), and lateral E/e' (r = -0.54, P = 0.01).<br />Conclusions: SCA patients have abnormal submaximal exercise measures compared with controls, which is strongly associated with abnormal maximal exercise results. The degree of submaximal abnormality correlates with DD abnormalities by echocardiography. These data expand the scope of functional cardiovascular abnormalities in SCA.<br /> (© 2019 Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Adult
Cardiomyopathies diagnosis
Case-Control Studies
Female
Follow-Up Studies
Humans
Incidence
Longitudinal Studies
Male
Ohio epidemiology
Prognosis
Prospective Studies
Respiratory Function Tests
Young Adult
Anemia, Sickle Cell physiopathology
Cardiomyopathies epidemiology
Exercise
Exercise Test
Oxygen metabolism
Oxygen Consumption
Subjects
Details
- Language :
- English
- ISSN :
- 1545-5017
- Volume :
- 66
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Pediatric blood & cancer
- Publication Type :
- Academic Journal
- Accession number :
- 30848046
- Full Text :
- https://doi.org/10.1002/pbc.27703