Schindel CS, Schiwe D, Heinzmann-Filho JP, Gheller MF, Campos NE, Pitrez PM, Donadio MVF. Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma.
J Asthma 2020;
59:115-125. [PMID:
33026845 DOI:
10.1080/02770903.2020.1833915]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE
To evaluate the exercise capacity of children and adolescents with severe therapy resistant asthma (STRA) aiming to identify its main determinants.
METHODS
Cross-sectional study including individuals aged 6-18 years with a diagnosis of STRA. Clinical (age and gender), anthropometric (weight, height and body mass index) and disease control data were collected. Lung function (spirometry), cardiopulmonary exercise testing (CPET) and exercise-induced bronchoconstriction (EIB) test were performed.
RESULTS
Twenty-four patients aged 11.5 ± 2.6 years were included. The mean forced expiratory volume in one second (FEV1) was 91.3 ± 9.2%. EIB occurred in 54.2% of patients. In CPET, the peak oxygen uptake (VO2peak) was 34.1 ± 7.8 mL kg-1 min-1. A significant correlation between ventilatory reserve and FEV1 (r = 0.57; p = 0.003) was found. Similarly, there was a significant correlation between CPET and percent of FEV1 fall in the EIB test for both VE/VO2 (r = 0.47; p = 0.02) and VE/VCO2 (r = 0.46; p = 0.02). Patients with FEV1<80% had lower ventilatory reserve (p = 0.009). In addition, resting heart rate correlated with VO2peak (r=-0.40; p = 0.04), VE/VO2 (r = 0.46; p = 0.02) and VE/VCO2 (r = 0.48; p = 0.01).
CONCLUSIONS
Exercise capacity is impaired in approximately 30% of children and adolescents with STRA. The results indicate that different aspects of aerobic fitness are influenced by distinct determinants, including lung function and EIB.
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