Nishiyama Osamu, Yamazaki Ryo, Sano Hiroyuki, Iwanaga Takashi, Higashimoto Yuji, Kume Hiroaki, Tohda Yuji
Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osakasayama, Osaka 589-8511, Japan.
Can Respir J. 2016;2016:3837182. doi: 10.1155/2016/3837182. Epub 2016 May 18.
Background. Six-minute walk test (6MWT) has 3 measurement outcomes, which are walk distance, desaturation, and symptom. The aim of this study was to examine whether routinely measured right-heart catheter (RHC) data correlate with 6MWT outcomes in patients with interstitial lung disease (ILD). Methods. Between June 2010 and December 2012, consecutive patients with ILD who underwent evaluation, including pulmonary function test, hemodynamic studies with right-heart catheter, and 6MWT as routine general practice, were recruited. Correlates of 3 outcomes of 6MWT were examined to reveal significant predictors. Results. Forty-six patients consisting of 20 with idiopathic pulmonary fibrosis, 14 with collagen vascular disease associated ILD, and 12 with other idiopathic interstitial pneumonia were recruited (mean % predicted FVC: 76.7 ± 17.1%). Several physiological variables, including mean pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR), were correlated with each 6MWT outcome. Stepwise multivariate regression analyses showed that % predicted FVC and % predicted DLco were independent predictors of walk distance (r (2) = 0.35, p = 0.0002). For SpO2 at the end of 6MWT, % predicted DLco and PVR were selected as independent predictors (r (2) = 0.46, p < 0.0001). For dyspnea at the end of 6MWT, % predicted DLco was only one predictor (r (2) = 0.18, p = 0.005). Conclusion. Mean PAP had little impact on 6MWT outcomes in ILD patients who were nonselectively recruited, although PVR was one of predictors of desaturation.
背景。六分钟步行试验(6MWT)有3项测量结果,即步行距离、血氧饱和度下降和症状。本研究的目的是检验在间质性肺疾病(ILD)患者中,常规测量的右心导管(RHC)数据是否与6MWT结果相关。方法。在2010年6月至2012年12月期间,连续纳入接受评估的ILD患者,这些评估包括肺功能测试、右心导管血流动力学研究以及作为常规诊疗项目的6MWT。对6MWT的3项结果的相关因素进行检查,以揭示显著的预测因素。结果。共纳入46例患者,其中20例为特发性肺纤维化,14例为胶原血管病相关ILD,12例为其他特发性间质性肺炎(预计FVC平均百分比:76.7±17.1%)。包括平均肺动脉压(PAP)和肺血管阻力(PVR)在内的几个生理变量与每项6MWT结果相关。逐步多元回归分析显示,预计FVC百分比和预计DLco百分比是步行距离的独立预测因素(r² = 0.35,p = 0.0002)。对于6MWT结束时的SpO₂,预计DLco百分比和PVR被选为独立预测因素(r² = 0.46,p < 0.0001)。对于6MWT结束时的呼吸困难,预计DLco百分比是唯一的预测因素(r² = 0.18,p = 0.005)。结论。在非选择性纳入的ILD患者中,平均PAP对6MWT结果影响不大,尽管PVR是血氧饱和度下降的预测因素之一。