Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital.
Rheumatology (Oxford). 2022 Oct 6;61(10):4113-4118. doi: 10.1093/rheumatology/keac020.
Cardiopulmonary involvement is a major cause of death in patients with SSc. This study evaluated the clinical utility and reliability of breath-holding test (BHT) in evaluating cardiopulmonary function in patients with SSc.
Seventy-two prospectively enrolled patients with SSc underwent BHT and the 6 min walk test (6MWT), along with measurements of the Borg dyspnoea scale and Scleroderma Health Assessment Questionnaire (SHAQ). Data on pulmonary function test and echocardiography were also collected. Validity was assessed based on the correlations between the best BHT and relevant clinical parameters. To assess the reliability of BHT, an additional 31 patients with SSc underwent BHTs twice within 2 week intervals.
Mean (s.d.) best BHT time was 38.4 (15.7) s, and 6MWT distance was 473.5 (95.5) m. BHT showed significant correlations with the Borg dyspnoea scale before (r = -0.367, P < 0.001) and after (r = -0.285, P = 0.016) testing, whereas 6MWT were correlated with the Borg dyspnoea scale after (r = -0.351, P = 0.002) but not before (r = -0.113, P = 0.343) testing. BHT time was correlated with diffusing capacity for carbon monoxide (%, r = 0.426, P < 0.001), forced vital capacity (litres, r = 0.373, P = 0.001), pulmonary arterial systolic pressure (mmHg, r = -0.272, P = 0.031) and SHAQ score (r = -0.470, P < 0.001), but not with left ventricular ejection fraction (%, r = -0.135, P = 0.263). BHT showed excellent reliability, with an intraclass correlation coefficient (2, 1) of 0.943 (95% CI: 0.88, 0.97).
BHT, a simple and less time-consuming test, shows excellent reliability and significant correlation with the Borg scale, SHAQ and pulmonary parameters. These results suggest that BHT might be a useful surrogate marker of pulmonary capacity in SSc patients.
NCT04484948.
心肺受累是系统性硬化症（SSc）患者死亡的主要原因。本研究评估屏气试验（BHT）评估 SSc 患者心肺功能的临床效用和可靠性。
72 例前瞻性纳入的 SSc 患者接受 BHT 和 6 分钟步行试验（6MWT），同时测量 Borg 呼吸困难量表和硬皮病健康评估问卷（SHAQ）。还收集了肺功能检查和超声心动图的数据。有效性基于最佳 BHT 与相关临床参数之间的相关性进行评估。为评估 BHT 的可靠性，另外 31 例 SSc 患者在 2 周内进行了两次 BHT。
最佳 BHT 时间的平均值（标准差）为 38.4（15.7）秒，6MWT 距离为 473.5（95.5）米。BHT 与测试前（r=-0.367，P<0.001）和测试后（r=-0.285，P=0.016）的 Borg 呼吸困难量表显著相关，而 6MWT 仅与测试后（r=-0.351，P=0.002）相关，与测试前（r=-0.113，P=0.343）无关。BHT 时间与一氧化碳弥散量（%，r=0.426，P<0.001）、用力肺活量（升，r=0.373，P=0.001）、肺动脉收缩压（mmHg，r=-0.272，P=0.031）和 SHAQ 评分（r=-0.470，P<0.001）相关，但与左心室射血分数（%，r=-0.135，P=0.263）无关。BHT 具有极好的可靠性，组内相关系数（2,1）为 0.943（95%CI：0.88，0.97）。
BHT 是一种简单且耗时更少的测试，具有极好的可靠性，与 Borg 量表、SHAQ 和肺参数具有显著相关性。这些结果表明，BHT 可能是 SSc 患者肺容量的有用替代标志物。
NCT04484948。
