Does Pseudomonas aeruginosa Colonization Affect Exercise Capacity in CF?

Elpis Hatziagorou,Vasiliki Georgopoulou,John Tsanakas,Asterios Kampouras,Fotios Kirvassilis,Vasiliki Avramidou

doi:10.1155/2019/3786245

Abstract

Introduction Cardio-Pulmonary Exercise Testing (CPET) has been recognized as a valuable method in assessing disease burden and exercise capacity among CF patients. Aim To evaluate whether Pseudomonas aeruginosa colonization status affects Exercise Capacity, LCI and High-Resolution Computed Tomography (HRCT) indices among patients with CF; to check if Pseudomonas colonization can predict exercise intolerance. Subjects Seventy-eight (78) children and adults with CF (31 males) mean (range) age 17.08 (6.75; 24.25) performed spirometry, Multiple Breath Washout (MBW) and CPET along with HRCT on the same day during their admission or follow up visit. Results 78 CF patients (mean FEV1: 83.3% mean LCI: 10.9 and mean VO2 peak: 79.1%) were evaluated: 33 were chronically colonized with Pseudomonas aeruginosa, 24 were intermittently colonized whereas 21 were Pseudomonas free. Statistically significant differences were observed among the three groups in: peak oxygen uptake % predicted (VO2 peak% (p < 0.001), LCI (p < 0.001), as well as FEV1% (p < 0.001) and FVC% (p < 0.001). Pseudomonas colonization could predict VO2 peak% (p < 0.001, r2: −0.395). Conclusion Exercise capacity as reflected by peak oxygen uptake is reduced in Pseudomonas colonized patients and reflects lung structural damages as shown on HRCT. Pseudomonas colonization could predict exercise limitation among CF patients.

Highlights

Cardio-Pulmonary Exercise Testing (CPET) has been recognized as a valuable method in assessing disease burden and exercise capacity among CF patients
Cystic Fibrosis lung disease is characterized by the presence and persistence of thick mucus secretions that are not cleared from the patient’s airways [1, 2]. is decreased mucus clearance predisposes to early colonization from pathogens, especially Pseudomonas aeruginosa (P. aeruginosa), leading to a vicious cycle of infection and in ammation [3]
Even though long-term e ects of P. aeruginosa colonization in VO2 peak have been made profound, no data exist on how exercise capacity of CF patients colonized compares to that of Pseudomonas-free and if such impairment exists, whether it is translated to structural lung damages as seen on High Resolution Computed Tomography (HRCT)

Summary

Introduction

Cystic Fibrosis lung disease is characterized by the presence and persistence of thick mucus secretions that are not cleared from the patient’s airways [1, 2]. is decreased mucus clearance predisposes to early colonization from pathogens, especially Pseudomonas aeruginosa (P. aeruginosa), leading to a vicious cycle of infection and in ammation [3]. Pseudomonas colonization has been shown to be a factor in uencing FEV1 decline in cystic brosis, increasing the hazard of developing severe lung disease to 2.4 times [4] and having a strong impact on overall prognosis. In CF, patients with VO2 peak values >80% predicted have been shown to present nearly excellent 10-year prognosis [5]. Pseudomonas colonization as a factor of in ammation and infection has been shown to a ect exercise capacity. Even though long-term e ects of P. aeruginosa colonization in VO2 peak have been made profound, no data exist on how exercise capacity of CF patients colonized compares to that of Pseudomonas-free and if such impairment exists, whether it is translated to structural lung damages as seen on High Resolution Computed Tomography (HRCT). Colonized with P. aeruginosa, intermittently colonized or free of any pathogen, and to investigate possible di erences in HRCT and whether any correlations with exercise capacity exist

Materials and Methods

Results