Chest
Clinical InvestigationsExerciseSarcoidosis: The Value of Exercise Testing
Section snippets
Materials and Methods
We studied sequential patients with biopsy specimen-provensarcoidosis who were referred to the Pulmonary Physiology Laboratoryfor clinical exercise testing between 1992 and 1997, who successfullycompleted 6 min of a progressive SLE test and had resting pulmonaryfunction, exercise testing, and posteroanterior and lateral chestradiographs performed within a 2-month period. Each pair of chestradiographs was examined and classified by two pulmonologists: stage 0, no radiographic abnormalities;
Results
Forty-eight individuals completed a minimum of 6 min of exercisetesting. The mean age of the subjects was 41 years, 17 were white, 24were African American, 8 were smokers, and 4 of the smokers had initial COHb measurements > 3%. No patient had clinical evidence of heartdisease. Seventeen patients were receiving treatment with one or moreof the following medications: clonidine, H2-receptor antagonists, ipratropium viametered-dose inhaler (MDI), albuterol via MDI, triamcinolone via MDI, insulin,
Discussion
We do not have a true noninvasive “gold standard” formeasuring the extent of disease in patients with pulmonary sarcoidosis. The American Thoracic Society, European Thoracic Society, and the World Association of Sarcoidosis and other Granulomatous Disorders haveissued a joint statement19 of recommendations forfollowing patients with pulmonary sarcoidosis. They recommendthat system review, physical examination, chest radiograph, andspirometry be performed regularly. These will suffice for
References (20)
- et al.
Gas exchange at a given degree of volume restriction is different in sarcoidosis and idiopathic pulmonary fibrosis
Am J Med
(1988) - et al.
Exercise alveolar-arterial oxygen pressure difference in interstitial lung disease
Chest
(1984) - et al.
Cardiorespiratory response to incremental exercise in sarcoidosis patients with normal spirometry
Chest
(1995) - et al.
Pulmonary sarcoidosis: radiographic, functional and pathologic correlation
Respiration
(1979) - et al.
The sequence of physiologic changes in pulmonary sarcoidosis: correlation with radiographic stages and response to therapy
Mt Sinai J Med
(1977) - et al.
Morphologic-physiologic correlates of the severity of fibrosis and degree of cellularity in idiopathic pulmonary fibrosis
J Clin Invest
(1979) - et al.
Abnormal oxygen uptake response to exercise in patients with mild sarcoidosis
Chest
(1992) Prognosis of intrathoracic sarcoidosis in England
BMJ
(1961)Official statement of the ATS: standardization of spirometry
Am J Respir Crit Care Med
(1995)Am Rev Respir Dis
(1978)
Cited by (46)
Consequences of Sarcoidosis
2015, Clinics in Chest MedicineInfluence of repeated maximal exercise testing on biomarkers and fatigue in sarcoidosis
2013, Brain, Behavior, and ImmunityCitation Excerpt :Fatigue is often reported by sarcoidosis patients, especially during the onset and the active phase of this multi-systemic granulomatous disorder (De Kleijn et al., 2009; Drent et al., 2012; De Vries et al., 2004). However, when sarcoidosis patients are tested for cardiovascular, pulmonary, and aerobic capacity by means of exercise tests, the results of these tests are usually within reference limits (Matthews and Hooper, 1983; Medinger et al., 2001; Costable, 2005). Nonetheless, many patients state that they are completely exhausted after completing the exercise test.
The impact of gas exchange measurement during exercise in pulmonary sarcoidosis
2011, Respiratory MedicineCitation Excerpt :Based on these findings we consider gas exchange measurement during exercise as suitable to become an integral part of assessment and monitoring in pulmonary sarcoidosis. Medinger and co-workers already suggested P(A-a)O2 during exercise to be a sensitive measure of the extent of pulmonary sarcoidosis.12 To our best knowledge, the P(A-a)O2 thresholds proposed by the ATS/ACCP statement, which we used, have not been evaluated in detail in sarcoidosis.15