Biomaterial Database

Exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis. 2008

K Terziyski, and V Andonov, and B Marinov, and S Kostianev

Department of Pathophysiology, Medical University of Plovdiv, Plovdiv, Bulgaria. k_terziyski@mail.orbitel.bg

1. The impact of ventilatory efficiency on reduced exercise capacity and recovery oxygen kinetics has not been addressed in cirrhotic patients. The aim of the present study was to investigate exercise performance and ventilatory efficiency in patients with mild and moderate liver cirrhosis (LC). 2. Nineteen male non-hypoxic patients with LC (age 51.3 +/- 9.1 years; body mass index (BMI) 25.6 +/- 3.6 kg/m(2)) classified by the Child-Pugh score as class A (n = 7) and class B (n = 12) and 19 age- and BMI-matched controls participated in the study. Subjects undertook maximal incremental exercise testing on a treadmill using the Bruce protocol. 3. Patients with LC showed a reduced diffusion capacity (D(L,CO)%) compared with controls (74.6 +/- 15.2 vs 95.6 +/- 12.9%, respectively; P < 0.001), but a comparable volume standardized diffusion coefficient (1.33 +/- 0.22 vs 1.45 +/- 0.18 mmol/min per kPa per L, respectively; P = 0.74). Patients with LC had a significantly lower exercise capacity compared with controls (VO(2 max) 23.8 +/- 3.8 vs 30.6 +/- 4.4 mL/min per kg, respectively; P < 0.001). Recovery oxygen kinetics were also impaired in LC patients compared with controls (104.6 +/- 19.3 vs 84.4 +/- 22.7 s, respectively; P = 0.012). The chronotropic index was significantly lower in the LC group compared with controls (0.67 +/- 0.19 vs 0.82 +/- 0.17, respectively; P = 0.030) and LC patients showed higher ventilatory equivalents (30.4 +/- 3.8 vs 26.3 +/- 2.3, respectively; P < 0.001) and lower oxygen uptake efficiency slope values (2187 +/- 445 vs 2745 +/- 473 mL/min per log(10)L, respectively; P < 0.001) compared with controls, which is indicative of decreased ventilatory efficiency. Patients with LC also had a higher standardized maximal exercise perception score (SMEPS) compared with controls (0.62 +/- 0.18 vs 0.46 +/- 0.15, respectively; P = 0.011). Moderate negative correlations were found between Child-Pugh score and VO(2 max)% (r = -0.496; P = 0.031). 4. In conclusion, patients with mild and moderate LC have reduced exercise capacity, which correlates with Child-Pugh score, as well as reduced chronotropic index and prolonged recovery oxygen uptake kinetics. The results suggest worsened ventilatory efficiency during exercise and cardiopulmonary reasons for the higher SMEPS in these patients.

UI	MeSH Term	Description	Entries
D007700	Kinetics	The rate dynamics in chemical or physical systems.
D008103	Liver Cirrhosis	Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules.	Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010101	Oxygen Consumption	The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346)	Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D011653	Pulmonary Diffusing Capacity	The amount of a gas taken up, by the pulmonary capillary blood from the alveolar gas, per minute per unit of average pressure of the gradient of the gas across the BLOOD-AIR BARRIER.	Capacity, Pulmonary Diffusing,Diffusing Capacity, Pulmonary
D011659	Pulmonary Gas Exchange	The exchange of OXYGEN and CARBON DIOXIDE between alveolar air and pulmonary capillary blood that occurs across the BLOOD-AIR BARRIER.	Exchange, Pulmonary Gas,Gas Exchange, Pulmonary
D012123	Pulmonary Ventilation	The total volume of gas inspired or expired per unit of time, usually measured in liters per minute.	Respiratory Airflow,Ventilation Tests,Ventilation, Pulmonary,Expiratory Airflow,Airflow, Expiratory,Airflow, Respiratory,Test, Ventilation,Tests, Ventilation,Ventilation Test
D005080	Exercise Test	Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.	Arm Ergometry Test,Bicycle Ergometry Test,Cardiopulmonary Exercise Testing,Exercise Testing,Step Test,Stress Test,Treadmill Test,Cardiopulmonary Exercise Test,EuroFit Tests,Eurofit Test Battery,European Fitness Testing Battery,Fitness Testing,Physical Fitness Testing,Arm Ergometry Tests,Bicycle Ergometry Tests,Cardiopulmonary Exercise Tests,Ergometry Test, Arm,Ergometry Test, Bicycle,Ergometry Tests, Arm,Ergometry Tests, Bicycle,EuroFit Test,Eurofit Test Batteries,Exercise Test, Cardiopulmonary,Exercise Testing, Cardiopulmonary,Exercise Tests,Exercise Tests, Cardiopulmonary,Fitness Testing, Physical,Fitness Testings,Step Tests,Stress Tests,Test Battery, Eurofit,Test, Arm Ergometry,Test, Bicycle Ergometry,Test, Cardiopulmonary Exercise,Test, EuroFit,Test, Exercise,Test, Step,Test, Stress,Test, Treadmill,Testing, Cardiopulmonary Exercise,Testing, Exercise,Testing, Fitness,Testing, Physical Fitness,Tests, Arm Ergometry,Tests, Bicycle Ergometry,Tests, Cardiopulmonary Exercise,Tests, EuroFit,Tests, Exercise,Tests, Step,Tests, Stress,Tests, Treadmill,Treadmill Tests
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man