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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

Ventilatory abnormalities in patients with cystic fibrosis undergoing the submaximal treadmill exercise test

BMC Pulmonary Medicine > Ausgabe 1/2015
Paloma Lopes Francisco Parazzi, Fernando Augusto de Lima Marson, Maria Angela Gonçalves de Oliveira Ribeiro, Celize Cruz Bresciani de Almeida, Luiz Cláudio Martins, Ilma Aparecida Paschoal, Adyleia Aparecida Dalbo Contrera Toro, Camila Isabel Santos Schivinski, Jose Dirceu Ribeiro
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12890-015-0056-5) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

PLFP, FALM, MAGOR, CISS, and JDR made substantial contributions to the study conception and design, acquisition of data, or analysis and interpretation of data; were involved in drafting the manuscript or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CCBA, IAP, and AADCT made substantial contributions to the study conception and design, acquisition of data, or analysis and interpretation of data. LCM was involved in drafting the manuscript and revising it critically for important intellectual content. All authors read and approved the final manuscript.



Exercise has been studied as a prognostic marker for patients with cystic fibrosis (CF), as well as a tool for improving their quality of life and analyzing lung disease. In this context, the aim of the present study was to evaluate and compare variables of lung functioning. Our data included: (i) volumetric capnography (VCAP) parameters: expiratory minute volume (VE), volume of exhaled carbon dioxide (VCO2), VE/VCO2, ratio of dead space to tidal volume (VD/VT), and end-tidal carbon dioxide (PetCO2); (ii) spirometry parameters: forced vital capacity (FVC), percent forced expiratory volume in the first second of the FVC (FEV1%), and FEV1/FVC%; and (iii) cardiorespiratory parameters: heart rate (HR), respiratory rate, oxygen saturation (SpO2), and Borg scale rating at rest and during exercise. The subjects comprised children, adolescents, and young adults aged 6–25 years with CF (CF group [CFG]) and without CF (control group [CG]).


This was a clinical, prospective, controlled study involving 128 male and female patients (64 with CF) of a university hospital. All patients underwent treadmill exercise tests and provided informed consent after study approval by the institutional ethics committee. Linear regression, Kruskal–Wallis test, and Mann–Whitney test were performed to compare the CFG and CG. The α value was set at 0.05.


Patients in the CFG showed significantly different VCAP values and spirometry variables throughout the exercise test. Before, during, and after exercise, several variables were different between the two groups; statistically significant differences were seen in the spirometry parameters, SpO2, HR, VCO2, VE/VCO2, PetCO2, and Borg scale rating. VCAP variables changed at each time point analyzed during the exercise test in both groups.


VCAP can be used to analyze ventilatory parameters during exercise. All cardiorespiratory, spirometry, and VCAP variables differed between patients in the CFG and CG before, during, and after exercise.
Additional file 1: Table S1. Genotypes for the CFTR mutations of patients with cystic fibrosis enrolled in the present study (n = 64).
Additional file 2: Table S2. CFTR mutations found in individuals enrolled in the study. Gene and protein localization. Mutation classification and frequency from the present study are designated. Traditional and Human Genome Variation Society standard nomenclature for CFTR mutations are also indicated.
Additional file 3: Table S3. Volumetric capnograph markers taking into account groups of patients with cystic fibrosis and healthy subjects. Time points analyzed by groups.
Additional file 4: Figure S4. Linear regression of VCO2 and FEV1% by body mass index (BMI). A. Time point 1 - VCO2 by BMI - [Combined: y = 12.382 + 0.031 x (p ≤ 0.001)], [CF: y = 12.381 + 0.025 x (p = 0.001)], [Control: y = 13.810 + 0.029 x (p ≤ 0.001)]. B. Time point 3 - VCO2 by BMI - [Combined: y = 12.573 x + 0.015 (p ≤ 0.001)], [CF: y = 12.278 + 0.013 x (p < 0.001)], [Control: y = 14.244 + 0.013 x (p ≤ 0.001)]. C. Time point 5 - VCO2 by BMI - [Combined: y = 11.854 x + 0.017 (p ≤ 0.001)], [CF: y = 11.712 + 0.015 x (p ≤ 0.001)], [Control: y = 13.266 + 0.016 x (p ≤ 0.001)]. D. Time point 1 - FEV1% by BMI - [Combined: y = 13.566 + 0.056 x (p = 0.001)], [CF: y = 15.127 + 0.023 x (p = 0.196)], [Control: y = 14.919 + 0.049 x (p = 0.133)].
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