Title
Frailty and maximal exercise capacity in adult lung transplant candidates
Date Issued
01 October 2017
Access level
open access
Resource Type
journal article
Author(s)
Layton A.M.
Armstrong H.F.
Podolanczuk A.J.
Pieszchata N.M.
Singer J.P.
Arcasoy S.M.
Meza K.S.
D'Ovidio F.
Lederer D.J.
Columbia University
Publisher(s)
W.B. Saunders Ltd
Abstract
Background Frail lung transplant candidates are more likely to be delisted or die without receiving a transplant. Further knowledge of what frailty represents in this population will assist in developing interventions to prevent frailty from developing. We set out to determine whether frail lung transplant candidates have reduced exercise capacity independent of disease severity and diagnosis. Methods Sixty-eight adult lung transplant candidates underwent cardiopulmonary exercise testing (CPET) and a frailty assessment (Fried's Frailty Phenotype (FFP)). Primary outcomes were peak workload and peak aerobic capacity (V˙O2). We used linear regression to adjust for age, gender, diagnosis, and lung allocation score (LAS). Results The mean ± SD age was 57 ± 11 years, 51% were women, 57% had interstitial lung disease, 32% had chronic obstructive pulmonary disease, 11% had cystic fibrosis, and the mean LAS was 40.2 (range 19.2–94.5). In adjusted models, peak workload decreased by 10 W (95% CI 4.7 to 14.6) and peak V˙O2 decreased by 1.8 mL/kg/min (95% CI 0.6 to 2.9) per 1 unit increment in FFP score. After adjustment, exercise tolerance was 38 W lower (95% CI 18.4 to 58.1) and peak V˙O2 was 8.5 mL/kg/min lower (95% CI 3.3 to 13.7) among frail participants compared to non-frail participants. Frailty accounted for 16% of the variance (R2) of watts and 19% of the variance of V˙O2 in adjusted models. Conclusion Frailty contributes to reduced exercise capacity among lung transplant candidates independent of disease severity.
Start page
70
End page
76
Volume
131
Language
English
OCDE Knowledge area
Sistema respiratorio
Sistema cardiaco, Sistema cardiovascular
Subjects
Scopus EID
2-s2.0-85029704139
PubMed ID
Source
Respiratory Medicine
ISSN of the container
09546111
Sponsor(s)
There are no conflicts of interest to report. This work was supported by NIH grants R01 HL114626 , K24 HL131937 , K23 HL111115 , K23 AG045560 , and the non-profit entities: Pulmonary Fibrosis Foundation , the Rocco Guinta Research Fund , and the Nina Ireland Research Fund .
Sources of information:
Directorio de Producción Científica
Scopus