Master of Cancer Care Program, School of Health Sciences, Saint Francis University, Loretto, Pennsylvania (Dr Vainshelboim); Pulmonary Institute, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel (Drs Vainshelboim, Izhakian, Unterman, and Kramer); Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Portugal (Drs Vainshelboim and Oliveira); Cardiology Division, Veterans Affairs Palo Alto Health Care System/Stanford University, California (Dr Myers); Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Izhakian, Unterman, and Kramer).
J Cardiopulm Rehabil Prev. 2019 May;39(3):193-198. doi: 10.1097/HCR.0000000000000362.
This pilot study aimed to compare physiological responses between cycle cardiopulmonary exercise tests (CPETs) and 6-min walk tests (6MWTs) and to assess their prognostic value among patients with idiopathic pulmonary fibrosis (IPF).
Thirty-four patients with IPF (68 ± 8 yr) underwent CPETs and 6MWTs and were followed up for 40 mo. Differences, levels of agreement, and relative risks for mortality were analyzed between measured and estimated peak responses for the 2 tests.
Compared with the CPET, oxygen uptake ((Equation is included in full-text article.)O2), heart rate (HR), and the nadir of SpO2 were lower during the 6MWT, whereas work rate (WR) was higher. Mean differences were as follows: (Equation is included in full-text article.)O2 =-1.9 mL/kg/min, 95% CI, -1.1 to -2.7, P < .001; HR =-9 beats/min, 95% CI, -4 to -14, P = .002; SpO2 =-6%, 95% CI, -4 to -7, P < .001; and WR = 9 W/min, 95% CI, 3 to 16, P = .008. Interclass correlations ranged from 0.84 to 0.90 and both tests demonstrated prognostic value for mortality.
Significant differences and variation in peak physiological responses were observed between cycle CPETs and 6MWTs in patients with IPF. However, good agreement was evident, suggesting that both tests provide value for clinical and research settings. Future studies should compare the physiological responses between treadmill CPETs and 6MWTs for prognostic utility in IPF.
本初步研究旨在比较特发性肺纤维化（IPF）患者的心肺运动测试（CPET）和 6 分钟步行测试（6MWT）的生理反应，并评估它们的预后价值。
34 名 IPF 患者（68±8 岁）接受了 CPET 和 6MWT，并随访了 40 个月。分析了两种测试的测量和估计峰值反应之间的差异、一致性水平和死亡的相对风险。
与 CPET 相比，6MWT 期间（Equation is included in full-text article.）O2、心率（HR）和 SpO2 的最低值较低，而工作率（WR）较高。平均差异如下：（Equation is included in full-text article.）O2=-1.9 mL/kg/min，95%CI，-1.1 至-2.7，P<0.001；HR=-9 beats/min，95%CI，-4 至-14，P=0.002；SpO2=-6%，95%CI，-4 至-7，P<0.001；WR=9 W/min，95%CI，3 至 16，P=0.008。组内相关系数范围为 0.84 至 0.90，两种测试均对死亡率具有预后价值。
在 IPF 患者中，CPET 和 6MWT 之间观察到峰值生理反应存在显著差异和变化。然而，存在良好的一致性，表明两种测试在临床和研究环境中均具有价值。未来的研究应该比较跑步机 CPET 和 6MWT 在 IPF 中的预后应用的生理反应。
