Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma. (2nd January 2022)

• Record Type: Journal Article
• Authors: Schindel, Cláudia Silva; Schiwe, Daniele; Heinzmann-Filho, João Paulo; Gheller, Mailise Fátima; Campos, Natália Evangelista; Pitrez, Paulo Márcio; Donadio, Márcio Vinícius Fagundes
• Is Part Of: Journal of asthma. Volume 59:Number 1(2022)
• Page Start: 115
• Page End: 125
• Publication Date: 2022-01-02
• Subjects: Aerobic fitness -- exercise-induced bronchoconstriction -- oxygen consumption -- lung function -- cardiopulmonary exercise testing; Asthma -- Periodicals; 616.238005
• DOI: 10.1080/02770903.2020.1833915
• Languages: English
• ISSNs: 0277-0903

Abstract

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 ( V O2peak ) 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 V E / V O2 ( r = 0.47; p = 0.02) and V E / V CO2 ( r = 0.46; p = 0.02). Patients with FEV1 <80% had lower ventilatory reserve ( p = 0.009). In addition, resting heart rate correlated with V O2peak (r=-0.40; p = 0.04), V E / V O2 ( r = 0.46; p = 0.02) and V E / V CO2 ( 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.