Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 6:e2005.
doi: 10.1002/pri.2005. Online ahead of print.

Estimating cardiopulmonary fitness with a new sampling technology in patients with rheumatoid arthritis-associated interstitial lung disease

Rafael Alexandre de Oliveira Deucher  1 , Luis Felipe da Fonseca Reis  1 , Jannis Vasileios Papathanasiou  2   3 , Beatriz Luiza Pinheiro Alves Azevedo  4 , Jéssica Gabriela Messias Oliveira  4 , Matheus Mello da Silva  1 , Rayanne Costa de Sales  1 , Beatriz Pereira Dos Santos  1 , Arthur de Sá Ferreira  1 , Agnaldo José Lopes  1   4   5
Affiliations

Estimating cardiopulmonary fitness with a new sampling technology in patients with rheumatoid arthritis-associated interstitial lung disease

Rafael Alexandre de Oliveira Deucher et al. Physiother Res Int. .

Abstract

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.

Keywords: exercise; pulmonary function testing; rehabilitation; rheumatoid arthritis.

PubMed Disclaimer

References

REFERENCES

    1. Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., Birnbaum, N. S., Burmester, G. R., Bykerk, V. P., Cohen, M. D., Combe, B., Costenbader, K. H., Dougados, M., Emery, P., Ferraccioli, G., Hazes, J. M. W., Hobbs, K., Huizinga, T. W. J., Kavanaugh, A., … Hawker, G. (2010). Rheumatoid arthritis classification criteria: An American College of Rheumatology/European Leaugue against Rheumatism collaborative initiative. Arthritis & Rheumatism, 62(9), 2569-2581. https://doi.org/10.1002/art.27584
    1. American Thoracic Society & American College of Chest Physicians. (2003). ATS/ACCP Statement on cardiopulmonary exercise testing, 2003. American Journal of Respiratory and Critical Care Medicine, 167(2), 211-277. https://doi.org/10.1164/rccm.167.2.211
    1. Ångström, L., Hörnberg, K., Sundström, B., Jonsson, S. W., & Södergren, A. (2020). Aerobic capacity is associated with disease activity and cardiovascular risk factors in early rheumatoid arthritis. Physiotherapy Research International, 25(3), e1833. https://doi.org/10.1002/pri.1833
    1. Assis, A. C. B., & Lopes, A. J. (2022). Functional exercise capacity in rheumatoid arthritis unrelated to lung injury: A comparison of women with and without rheumatoid disease. Journal of Back and Musculoskeletal Rehabilitation, 35(2), 449-458. https://doi.org/10.3233/BMR-210056
    1. Bessa, E. J. C., Ribeiro, F. M. C., Pinheiro, G. R. C., & Lopes, A. J. (2019). Does the nitrogen single-breath washout test contribute to detecting pulmonary involvement in rheumatoid arthritis? A pilot study. BMC Research Notes, 12(1), 730. https://doi.org/10.1186/s13104-019-4767-1

LinkOut - more resources