The Role of Cardiopulmonary Exercise Testing in Assessment of Patients with Interstitial Lung Disease

Abstract

Abstract Background Cardiopulmonary exercise testing (CPET) is considered as the gold standard for evaluating the causes of exercise intolerance in patients with pulmonary and cardiac disease, and is based on the principle that system failure typically occurs while the system (e.g muscle-energetic, cardiovascular or pulmonary) is under stress. Objective To evaluate the role of cardiopulmonary exercise test in assessment of patients with interstitial lung disease. Patients and Methods This is observational study included 30 consecutive examined with the diagnosis of ILDs in Kobry El Kopa military hospital. The study was carried out over the period from February 2016 to August 2019. All patients with dyspnea to be investigated and ILDs diagnosed and assessed in rehabilitation department who undergo cardio pulmonary exercise test. Results Reduction on the compliance of the lung and/ or chest wall cause change in lung volumes and tachypnea during exercise. Also agreed with harris EzeAo Who showed that alterations on breathing pattern such as lower Vt, increased respiratory effort, rapid shallow breathing were reported in individual with interstitial lung diseases. Conclusion The pathophysiology of ILD has a negative impact on the ventilatory, cardiovascular, and skeletal muscle responses to exercise, thereby leading to exertional dyspnea and reduced exercise capacity. CPET is an excellent tool for assessing the severity of exertional dyspnea and mechanisms of exercise limitation in patients with various forms of cardiorespiratory disease; however, its application in ILD has remained limited. A growing body of evidence supports the use of CPET in patients with ILD. CPET is currently used to assess functional capacity, to inform exercise prescription, and to evaluate the effects of various interventions. Recent findings highlight that, in addition to its current uses, CPET-derived measures may help improve the management of patients with ILD. Despite these recent advances, additional research is required in order to confirm the utility of CPET in this population.