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Erschienen in: Lung 5/2017

08.08.2017

Patient-Reported Dyspnea Correlates Poorly with Aerobic Exercise Capacity Measured During Cardiopulmonary Exercise Testing

verfasst von: Dany Gaspard, Jonathan Kass, Stephen Akers, Krystal Hunter, Melvin Pratter

Erschienen in: Lung | Ausgabe 5/2017

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Abstract

Background

Patient-reported dyspnea plays a central role in assessing cardiopulmonary disease. There is little evidence, however, that dyspnea correlates with objective exercise capacity measurements. If the correlation is poor, dyspnea as a proxy for objective assessment may be misleading.

Objective

To compare patient’s perception of dyspnea with maximum oxygen uptake (MaxVO2) during cardiopulmonary exercise testing (CPET).

Methods

Fifty patients undergoing CPET for dyspnea evaluation were studied prospectively. Dyspnea assessment was measured by a metabolic equivalent of task (METs) table, Mahler Dyspnea Index, Borg Index, number of blocks walked, and flights of stairs climbed before stopping due to dyspnea. These descriptors were compared to MaxVO2.

Results

MaxVO2 showed low correlation with METs table (r = 0.388, p = 0.005) and no correlation with Mahler Index (r = 0.24, p = 0.093), Borg Index (r = −0.017, p = 0.905), number of blocks walked (r = 0.266, p = 0.077) or flights of stairs climbed (r = 0.188, p = 0.217). When adjusted for weight (maxVO2/kg), there was significant correlation between MaxVO2 and METs table (r = 0.711, p < 0.001), moderate correlation with blocks walked (r = 0.614, p < 0.001), and low correlation with Mahler Index (r = 0.488 p = 0.001), Borg Index (r = −0.333 p = 0.036), and flights of stairs (r = 0.457 p = 0.004). Subgroup analysis showed worse correlation when patients with normal CPET were excluded (12/50 excluded). Patients with BMI < 30 had no correlation between Max VO2 and the assessment methods, while patients with BMI > 30 had moderate correlation between MaxVO2 and METs table (r = 0.568, p = 0.002).

Conclusion

Patient-reported dyspnea correlates poorly with MaxVO2 and fails to predict exercise capacity. Reliance on reported dyspnea may result in suboptimal categorization of cardiopulmonary disease severity.
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Metadaten
Titel
Patient-Reported Dyspnea Correlates Poorly with Aerobic Exercise Capacity Measured During Cardiopulmonary Exercise Testing
verfasst von
Dany Gaspard
Jonathan Kass
Stephen Akers
Krystal Hunter
Melvin Pratter
Publikationsdatum
08.08.2017
Verlag
Springer US
Erschienen in
Lung / Ausgabe 5/2017
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-017-0043-0

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