Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “EXERCISE TEST”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed2004

Preoperative spirometry versus expired gas analysis during exercise testing as predictors of cardiopulmonary complications after lung resection.

PURPOSE: As cardiopulmonary load increases with the amount of lung resected, to perform surgery safely it is important to be able to predict cardiopulmonary insufficiency. However, lung function testing with spirometry and blood gas analysis does not accurately measure cardiopulmonary reserve. We conducted this study to evaluate expired gas analysis during exercise testing for predicting postoperative complications after lung resection. METHODS: Expired gas analysis during exercise and spirometry were done 1 week preoperatively in 211 patients who underwent pulmonary resection for lung cancer. Patients were divided postoperatively according to whether cardiopulmonary complications were absent (group A) or present (group B). RESULTS: In group B there were more men than women (P < 0.01), and the mean age was greater (P < 0.05). There was no difference in disease stage, but more patients underwent pneumonectomy in group B than in group A ( P < 0.005). The results of expired gas analysis during exercise testing and of spirometry showed that maximum oxygen uptake/m(2) (P < 0.0005), anaerobic threshold/m(2) (P < 0.01), vital capacity (VC)/m(2) (P < 0.005), %VC (P < 0.0001), forced expiratory volume in 1 s (FEV(1.0))/m(2) (P < 0.0001), and FEV(1.0%) (P < 0.05) were lower in group B than in group A. CONCLUSIONS: The combination of expired gas analysis during exercise and conventional pulmonary function tests identified patients at risk for postoperative cardiopulmonary complications following pulmonary resection.

Aged↗
PubMed1975

[Value of the exercise test in the functional evaluation of non-coronary cardiac patients].

72 cardiac patients underwent an exercise test on the bicycle ergometer, with direct measurement of the oxygen consumption (VO2). These results are compared with those of 55 healthy subjects undergoing the same test. The amount of handicap varied with the nature of the cardiac lesion, being 39% for the mitral and cardiomyopathy groups, 31% for those with both mitral and aortic valve disease, 27% for the aortic valve group, and 25% for those with congenital abnormalities. The linear relationship between Watts and VO2 was reproduced both in the healthy and cardiac subjects, which allows us to calculate the value of VO2 under conditions of load for more than 3 minutes during a standardized exercise test.

Adult↗
PubMed1998

Muscle anaerobic response to a maximal treadmill exercise test in Standardbred trotters.

The purpose of this study was to develop a standardised maximal treadmill exercise test performed until fatigue in order to find reproducible markers for anaerobic metabolism, specifically adenine nucleotide degradation. Six Standardbred trotters performed an incremental maximal treadmill exercise test in 1 min steps (starting with 7 m/s) until they could no longer keep pace with the treadmill. The test was performed twice with at least one week between the tests. Heart rate was recorded and venous blood samples were obtained during the test and in the recovery period for determination of plasma lactate, hypoxanthine, xanthine and uric acid. Muscle biopsy samples (m. gluteus) were collected at rest, immediately post exercise, and after 15 min recovery and analysed for their concentrations of glycogen, creatine phosphate (CP), adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), inosine monophosphate (IMP) and muscle lactate (MLa). Significant decreases in glycogen, CP and ATP and significant increases in IMP and MLa were seen immediately post exercise. None of these metabolites had returned to resting levels after 15 min of recovery. A marked increase in plasma lactate (PLa) occurred during exercise and the peak concentration (mean value = 27.2 mmol/l) was reached within 5 min of recovery. Plasma uric acid concentration did not increase during exercise but rose markedly immediately post exercise, reaching the highest level (mean value = 121.5 micromol/l) at 20-30 min recovery. The duration of the maximal test was related to peak PLa and the uric acid concentration at 30 min of recovery. A correlation was also found between the ATP and IMP concentrations immediately post exercise and the plasma uric acid concentration at 30 min of recovery. The results show that this treadmill test triggered anaerobic metabolism and also that uric acid concentration post exercise seems to be a marker for the adenine nucleotide degradation that occurs during intense exercise. No significant differences were seen in metabolic response between the 2 test occasions.

Adenosine Diphosphate↗
PubMedDate not supplied

Better decisions through science: exercise testing scores.

Statistical tools can be used to create scores for assisting in the diagnosis of coronary artery disease and assessing prognosis. General practitioners and internists frequently function as gatekeepers, deciding which patients must be referred to the cardiologist. Therefore, they need to use the basic tools they have available (ie, history, physical examination and the exercise test) in an optimal fashion. Scores derived from multivariable statistical techniques considering clinical and exercise data have demonstrated superior discriminating power compared with diagnosis only using the ST segment response. In addition, by stratifying patients as to probability of disease and prognosis, they provide a more practical management strategy than a response of normal or abnormal. Although computers, as part of information management systems, can calculate complicated equations and derive these scores, physicians are reluctant to trust them. However, when represented as nomograms or simple additive discrete pieces of information, scores are more readily accepted. The scores have been compared with physician judgment and have been found to estimate the presence of coronary disease and prognosis as well as expert cardiologists and often better than nonspecialists. However, the discriminating power of specific variables from the medical history and exercise test remains unclear because of inadequate study design and differences in study populations. Should expired gases be substituted for estimated METs? Should ST/heart rate index be used instead of putting ST depression and heart rate separately into the models? Should right-sided chest leads and heart rate in recovery be considered? There is a need for further evaluation of these easily obtained variables to improve the accuracy of prediction algorithms, especially in women. The portability and reliability of scores must be ensured because access to specialized care must be safeguarded. Assessment of the clinical and exercise test data and application of the newer scores can empower the clinician to assure the cardiac patient access to appropriate and cost-effective cardiologic care.

Age Factors↗
PubMed2004

Influence of inspiratory resistance on performance during graded exercise tests on a cycle ergometer.

Due to more stringent requirements to protect personnel against hazardous gasses, the inspiratory resistance of the present generation of respiratory protective devices tends to increase. Therefore an important question is to what extent inspiratory resistance may increase without giving problems during physical work. In this study the effects of three levels (0.24; 1.4 and 8.3 kPa s l(-1)) of inspiratory resistance were tested on maximal voluntary performance. Nine male subjects performed a graded exercise test on a cycle ergometer with and without these three levels of inspiratory resistance. Oxygen consumption, heart rate, time to exhaustion and external work were measured. The results of these experiments showed that increasing inspiratory resistance led to a reduction of time to exhaustion (TTE) on a graded exercise test(GXT). Without inspiratory resistance the mean TTE was 11.9 min, the three levels of resistance gave the following mean TTE's: 10.7, 7.8 and 2.7 min. This study showed that TTE on a GXT can be predicted when physical fitness (VO2-max) of the subject and inspiratory resistance are known. The metabolic rate of the subjects was higher with inspiratory resistance, but no differences were found between the three selected inspiratory loads. Other breathing parameters as minute ventilation, tidal volume, expiration time and breathing frequency showed no or minor differences between the inspiratory resistances. The most important conclusion of these experiments is that the overall workload increases due to an increase in inspiratory resistance by wearing respiratory protective devices.

Adolescent↗
PubMed1984

Exercise test in patients over 65 years of age after the first myocardial infarction.

In 171 patients a submaximal exercise test was performed 3-6 weeks after the first acute myocardial infarction. No complications in connection with exercise test were observed. The incidence of ST/T-segment changes was significantly higher in patients over age 50. Patients over age 60 have a significantly higher incidence of PVCs as well as complex ventricular arrhythmias. In this patient group the incidence of ventricular arrhythmias was higher in patients with ST/T-segment changes during exercise. In the younger patients there was no correlation between incidence of ST/T-segment changes and arrhythmias. A high percentage of patients with no arrhythmias during exercise also had no arrhythmias during Holter. During follow up the average mortality rate was 3.6% and was not significantly different in the four age groups.

Aged↗
PubMed1997

Assessment of ischemic changes by ambulatory ECG-monitoring: comparison with 12-lead ECG during exercise testing.

The accuracy of commercially available ambulatory electrocardiographic monitoring (AEM) systems for reproducing ischemic changes has been questioned. Since these systems are widely used for evaluation of ST-segment changes, both for prognostic purposes and for assessment of the efficacy of antiischemic drugs, such doubts must be clarified. For this purpose, we recorded electrocardiograms (ECGs) during exercise testing, using split leads, simultaneously with a 12-lead electrocardiograph and with the Marquette AEM recorder. We studied 29 patients with proven coronary artery disease and positive exercise tests and 19 individuals with low likelihood of coronary artery disease and negative stress tests. All 29 patients who had ST-segment depression during exercise as recorded on the 12-lead ECG had ST-segment depression in at least one of the three AEM leads (resembling the V5, V3, and aVF leads of the 12-lead system). The maximal degree of ST-segment depression with AEM was similar to 12-lead ECG (2.3 mm and 2.1 mm, respectively). The best lead for ischemia detection with AEM was the V5 type, which detected ischemic changes in 26 of the 29 patients, while the 12-lead V5 detected ischemia in 24 patients. The inferior AEM lead detected ischemia in only 4 patients, while the aVF lead of the 12-lead ECG detected ischemia in 23 patients. Of the 19 patients with negative exercise tests only 1 patient had a 1-mm ST-segment depression on AEM. Thus, of the 48 patients studied, similar responses were observed in 47. The results of indicate that the Marquette AEM system is as accurate as the 12-lead ECG in detecting ischemic changes and in assessing their severity.

Aged↗
PubMed1998

Detection of the change point in oxygen uptake during an incremental exercise test using recursive residuals: relationship to the plasma lactate accumulation and blood acid base balance.

The purpose of this study was to develop a method to determine the power output at which oxygen uptake (VO2) during an incremental exercise test begins to rise non-linearly. A group of 26 healthy non-smoking men [mean age 22.1 (SD 1.4) years, body mass 73.6 (SD 7.4) kg, height 179.4 (SD 7.5) cm, maximal oxygen uptake (VO2max) 3.726 (SD 0.363) l x min(-1)], experienced in laboratory tests, were the subjects in this study. They performed an incremental exercise test on a cycle ergometer at a pedalling rate of 70 rev x min(-1). The test started at a power output of 30 W, followed by increases amounting to 30 W every 3 min. At 5 min prior to the first exercise intensity, at the end of each stage of exercise protocol, blood samples (1 ml each) were taken from an antecubital vein. The samples were analysed for plasma lactate concentration [La]pl, partial pressure of O2 and CO2 and hydrogen ion concentration [H+]b. The lactate threshold (LT) in this study was defined as the highest power output above which [La-]pl showed a sustained increase of more than 0.5 mmol x l(-1) x step(-1). The VO2 was measured breath-by-breath. In the analysis of the change point (CP) of VO2 during the incremental exercise test, a two-phase model was assumed for the 3rd-min-data of each step of the test: Xi = at(i) + b + epsilon(i) for i = 1,2, ..., T, and E(Xi) > at(i) + b for i = T + 1, ..., n, where X1, ..., Xn are independent and epsilon(i) approximately N(0, sigma2). In the first phase, a linear relationship between VO2 and power output was assumed, whereas in the second phase an additional increase in VO2 above the values expected from the linear model was allowed. The power output at which the first phase ended was called the change point in oxygen uptake (CP-VO2). The identification of the model consisted of two steps: testing for the existence of CP and estimating its location. Both procedures were based on suitably normalised recursive residuals. We showed that in 25 out of 26 subjects it was possible to determine the CP-VO2 as described in our model. The power output at CP-VO2 amounted to 136.8 (SD 31.3) W. It was only 11 W -- non significantly -- higher than the power output corresponding to LT. The VO2 at CP-VO2 amounted to 1.828 (SD 0.356) l x min(-1) was [48.9 (SD 7.9)% VO2max]. The [La-]pl at CP-VO2, amounting to 2.57 (SD 0.69) mmol x l(-1) was significantly elevated (P < 0.01) above the resting level [1.85 (SD 0.46) mmol x l(-1)], however the [H+]b at CP-VO2 amounting to 45.1 (SD 3.0) nmol x l(-1), was not significantly different from the values at rest which amounted to 44.14 (SD 2.79) nmol x l(-1). An increase of power output of 30 W above CP-VO2 was accompanied by a significant increase in [H+]b above the resting level (P = 0.03).

Acid-Base Equilibrium↗
PubMed1984

[Exercise test in isolated anomalies of auriculo-ventricular conduction in children and adolescents. Value in idiopathic auriculo-ventricular blocks and ventricular pre-excitation syndromes].

Abnormal atrioventricular conduction in children and adolescents without obvious underlying cardiac disease poses the problem of long term prognosis. This study of 45 patients aged 8 to 18 years with congenital atrioventricular block (30 cases) or ventricular pre-excitation (15 cases), was undertaken to determine the value of exercise testing, a physiological adrenergic stress test, in the assessment of these patients. Our results show that exercise testing was valuable in determining the site of atrioventricular block: during exercise the degree of block increased in two patients, justifying electrophysiological investigations which showed infrahisian block in one case; when the block was stable or improved on exercise, the atropine test, performed in 21 cases, gave concordant results in 18 cases (the same change with atropine and exercise): the block was nodal in all these patients. A concordant response to exercise and atropine, improving the degree of block, indicates suprahisian block and endocavitary investigation would not seem to be necessary. On the other hand, when the degree of block increases or remains the same during exercise and/or the atropine test, the site of block cannot be predicted and endocavitary investigation and Holter monitoring may be required. In patients with ventricular pre-excitation, exercise testing provides information on the relative values of the effective refractory periods of the normal and accessory pathways: in the 10 cases in which endocavitary studies were undertaken, the exercise electrocardiogram changed in the expected manner (disappearance of the pre-excitation wave on exercise in patients with accessory pathways with longer refractory periods than the normal pathway and persistence of pre-excitation when the accessory pathway refractory period was shorter).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Long-term prediction of major ischemic events by exercise thallium-201 single-photon emission computed tomography. Incremental prognostic value compared with clinical, exercise testing, catheterization and radionuclide angiographic data.

OBJECTIVES: This study sought to evaluate the prognostic role of exercise thallium-201 (Tl-201) single-photon emission computed tomography (SPECT) in patients with known or suspected coronary artery disease. BACKGROUND: Compared with planar Tl-201 scintigraphy, Tl-201 SPECT allows enhanced assessment of myocardial perfusion abnormalities. However, the long-term prognostic value of exercise Tl-201 SPECT has not been ascertained and compared with that of other techniques of investigation. METHODS: Predictors of ischemic events were sought in 217 patients with known or suspected coronary artery disease who underwent exercise Tl-201 SPECT, coronary angiography and rest radionuclide angiography and who initially received medical therapy. Predictive values were determined using Cox proportional hazards regression models. RESULTS: During a mean (+/- SD) follow-up period of 70 +/- 19 months, 29 patients had a major ischemic event (cardiac death or myocardial infarction). Total extent of exercise defects was the best independent predictor by Tl-201 SPECT of major events (p < 0.001) and provided additional prognostic information compared with clinical, exercise testing and catheterization variables (p < 0.02). Extent of reversible Tl-201 SPECT perfusion defects provided additional prognostic information compared with extent of irreversible defects (p < 0.001) and was the sole Tl-201 SPECT variable providing additional prognostic information compared with radionuclide left ventricular ejection fraction (p < 0.02). CONCLUSIONS: Total extent of exercise Tl-201 SPECT defects is a powerful long-term predictor of major ischemic events that enhances the prediction provided by clinical, exercise testing and coronary angiographic data. In view of its prognostic significance, extent of reversible Tl-201 SPECT defects might provide original information about improving prognosis by coronary revascularization.

Age Factors↗
PubMed2000

Prognostic value of neurohormonal activation and cardiopulmonary exercise testing in patients with chronic heart failure.

We compared the value of plasma neurohormones and cardiopulmonary exercise testing for predicting long-term prognosis in patients with moderate congestive heart failure (CHF). We studied 264 consecutive patients with CHF due to left ventricular systolic dysfunction. Plasma atrial natriuretic peptide (ANP), norepinephrine, and endothelin-1 were measured at rest in all patients, who also underwent a symptom-limited maximal exercise with oxygen consumption (VO(2)) determination. After a median follow-up of 789 days, 52 deaths and 31 heart transplantations occurred, of which 4 were urgent. In an univariate analysis, New York Heart Association functional class, systolic blood pressure at rest, left ventricular end-diastolic diameter, left ventricular ejection fraction, peak VO(2), percent of predicted peak VO(2), plasma ANP, plasma norepinephrine, and plasma endothelin-1 were associated with survival without urgent heart transplantation. In a multivariate stepwise regression analysis, only plasma ANP (p = 0.0001), left ventricular ejection fraction (p = 0.007), and plasma norepinephrine (p = 0.035), but neither peak VO(2) nor percentage of predicted peak VO(2), were independent predictors of death or urgent heart transplantation. Determination of plasma ANP and norepinephrine provides additional independent information for long-term prognostic determination compared with exercise testing alone. Measurement of plasma neurohormones should therefore be considered routinely as a complementary or alternative tool for identifying high-risk patients with moderate CHF.

Atrial Natriuretic Factor↗
PubMed1997

Exercise tests in large groups of children are not a suitable screening procedure for undiagnosed asthma.

Schoolchildren (n = 473), 12-13 years of age, from five schools, and without known asthma, participated in a screening test for exercise-induced asthma (EIA). The children were tested in large groups of 10-15 pupils. Peak expiratory flow (PEF) was measured before, immediately after, and 6-8 min after 6 min of running exercises in a gymnasium. A fall in PEF of at least 10% on two separate test occasions was considered an abnormal result. Children with abnormal results were given an asthma questionnaire and then tested individually in hospital with a standardized exercise test measuring FEV1, PEF, and flow/volume curve. In the screening test, 23 (4.9%) of the 473 children had an abnormal result. When tested in hospital, five (1%) children had a decrease in PEF and/or FEV1 of at least 10% (10-14%) after exercise. Furthermore, three of these five children had a history indicating mild EIA. We conclude that the use of PEF measurement as a screening method for EIA in large groups of schoolchildren cannot be recommended because it yields many false-positive results.

Adolescent↗
PubMed1992

Prognostic value of thallium-201 exercise scintigraphy in low-risk patients after Q-wave myocardial infarction: comparison with exercise testing and catheterization.

In a prospective study of 100 consecutive patients discharged after a Q-wave myocardial infarction, the value of reversible ischemia on thallium-201 scintigraphy to assess the risk of cardiac events (death or reinfarction) during 4 years was compared with variables from exercise testing and cardiac catheterization. Patients with markedly impaired left ventricular function [ejection fraction (EF) < or = 0.30] were excluded. During follow-up there were 20 cardiac events (10 cardiac deaths and 10 reinfarctions). Thallium-201 scintigraphy was significantly better than all exercise test variables and better than an EF < 0.40, with good sensitivity and specificity (75 and 51%, respectively). Exercise-induced reversible ischemia on scintigraphy yielded the same information as the presence of multivessel disease. Exercise test variables were of limited value to assess prognosis. Thus, thallium-201 scintigraphy can be used as the only tool to predict future cardiac events in low-risk patients after a Q-wave myocardial infarction.

Adult↗
PubMed1995

Dyspnea and exercise testing in workers exposed to silica.

In order to provide a better objective assessment of exertional dyspnea and functional impairment due to exposure to silica, 153 workers exposed to silica dust (workers) and 62 patients with silicosis (patients) were performed the medical questionnaires with special reference to exertional dyspnea and exercise testing on bicycle ergometer. Complaints of breathlessness were present in 77 (50%) workers and 53 (85%) patients. The findings of exercise tests indicated that there were definite correlations between index of dyspnea (ID), or breathing reserve (BR) and complaint of breathlessness in both the workers and patients. ID increased and BR decreased with the increasing degree of breathlessness. We defined ID > 70% or BR < 25 I/min as abnormal criteria and checked the ratios of dyspnea quantified objectively. Thus, 30% of the workers and 56% of the patients in this study were verified to have slight or moderate breathlessness, which were considerably lower than that derived from questionnaire on dyspnea. OUr results suggest that objective physiological measures like exercise testing may be of value in evaluating dyspnea in workers exposed to silica.

Adult↗
PubMed2005

Assessing cardiorespiratory fitness without performing exercise testing.

BACKGROUND: Low cardiorespiratory fitness (CRF) is associated with increased risk of chronic diseases and mortality; however, CRF assessment is usually not performed in many healthcare settings. The purpose of this study is to extend previous work on a non-exercise test model to predict CRF from health indicators that are easily obtained. METHODS: Participants were men and women aged 20 to 70 years whose CRF level was quantified with a maximal or submaximal exercise test as part of the National Aeronautics and Space Administration/Johnson Space Center (NASA, n = 1863), Aerobics Center Longitudinal Study (ACLS, n = 46,190), or Allied Dunbar National Fitness Survey (ADNFS, n = 1706). Other variables included gender, age, body mass index, resting heart rate, and self-reported physical activity levels. RESULTS: All variables used in the multiple linear regression models were independently related to the CRF in each of the study cohorts. The multiple correlation coefficients obtained within NASA, ACLS, and ADNFS participants, respectively, were 0.81, 0.77, and 0.76. The standard error of estimate (SEE) was 1.45, 1.50, and 1.97 metabolic equivalents (METs) (1 MET = 3.5 ml O(2) uptake.kilograms of body mass(-1).minutes(-1)), respectively, for the NASA, ACLS, and ADNFS regression models. All regression models demonstrated a high level of cross-validity (0.72 < R < 0.80). The highest cross-validation coefficients were seen when the NASA regression model was applied to the ACLS and ADNFS cohorts (R = 0.76 and R = 0.75, respectively). CONCLUSIONS: This study suggests that CRF may be accurately estimated in adults from a non-exercise test model including gender, age, body mass index, resting heart rate, and self-reported physical activity.

Adult↗
PubMed1990

Pacemaker syndrome evaluated by cardiopulmonary exercise testing.

Two patients who presented with dyspnea on effort, persisting after insertion of a fixed rate ventricular demand pacemaker (VVI) for sick sinus syndrome, were evaluated by cardiopulmonary exercise testing. During VVI pacing a heightened ventilatory response to exercise and a fluctuation of ventilation occurred. The high ventilatory equivalent for CO2 throughout exercise with VVI pacing suggests that the patients had ventilation-perfusion mismatching due to an increase in the pulmonary capillary wedge pressure caused by 1:1 ventriculoatrial conduction. Rate responsive ventricular (VVIR) pacing associated with intact 1:1 ventriculoatrial conduction exaggerated the exertional dyspnea, while rate responsive atrial (AAIR) pacing improved the ventilatory response to exercise. We suggest that a heightened ventilatory response to exercise due to ventilation-perfusion mismatching may be an important factor causing the pacemaker syndrome, and that cardiopulmonary exercise testing is useful in identifying the exercise-induced symptoms with ventricular pacing.

Aged↗
PubMed2004

[Usefulness of exercise test and peak inspiratory flow (PIF) measurement in diagnosis and management of bronchial asthma].

The purpose of this manuscript is to define the benefit of exercise test and peak inspiratory flow (PIF) measurement in adult patients with bronchial asthma. Seventy-seven patients--forty-seven from examined group (21 women, 26 men) and thirty patients from control group (8 women, 22 men) participated in this study. Exercise tests (ET) were performed in all subjects in the beginning of the study (ET1) then repeated two months later (ET2) only to the examined group. Patients exercised on a bicycle ergometer for 8-10 minutes to increase the hart rate to submaximal level. Spirometry were performed before and after the study and 5, 10, 15 and 20 minutes later. Symptoms of asthma after exercise and forced expiratory flow in one second (FEV1) decrease more then 15% of predicted value confirmed the diagnosis (positive test result). Thirty patients (74.4%) from examined group had positive results in ET1 and twelve (25.5%)--negative. Four patients (10%) were positive in ET2 and thirty-six (90%)--negative. deltaFEV1 decrease in ET2 was (-14.78%), in ET2 (-4.45%) p < 0.0001. There were twenty-nine (96.6%) negative results in control group, only one (3.4%) positive, p < 0.001. During the study no side effects were observed. The comparison of deltaPIF decrease in ET1 (-11.94%) and ET2 (-7.39%) shows significant difference p < 0.05. PIF decrease was not statistically different between control and study group. Results of the study suggest that exercise tests are safe and easy method of diagnosis and management of asthma. PIF measurement seems to be non-useful in diagnosis of bronchial asthma. It must be confirmed in further studies.

Adult↗
PubMed1989

Diagnostic value of exercise testing in asbestosis.

The diagnostic value of simple exercise testing was examined in 81 current male asbestos-cement workers, divided into four groups according to the International Labour Office (ILO) category of irregular opacities: 0/0, 25; 1/1, 24; 1/2, 22; and 2/2, 10 men. An increasing X-ray score was accompanied by more severe functional abnormality in keeping with the development of a restrictive defect. Symptom-limited oxygen uptake (VO2SL) did not depend on the X-ray grade and was 76.7, 71.9, 68.7, and 73.5% pv, respectively, for the four groups. Subjects with ILO score 1/1 had significantly higher exercise ventilation at O2 uptake of 1.01.min-1 (VE 1.0) than those with grade 0/0. End-exercise tidal volume (VTSL in 1) decreased with an increasing X-ray score: 2.14, 1.98, 1.85, and 1.62, respectively. VTSL standardized for vital capacity (VTSL/VC) followed the same pattern. Asbestosis was diagnosed in 25 men, in whom VE 1.0 was significantly higher (p less than .02) and VTSL lower (p less than .01) than in the 0/0 group. VO2SL was similar in both groups. The findings suggest that VE 1.0 and VTSL may be early functional indicators of asbestos-related interstitial lung fibrosis. The measurement of both exercise indices may increase the certainty of clinical diagnosis of asbestosis in subjects with less advanced disease.

Adult↗