Cardiopulmonary responses to exercise in women with sickle cell anemia

American Journal of Respiratory and Critical Care Medicine
Leigh A CallahanBernard Gutin

Abstract

Multiple factors contribute to exercise intolerance in patients with sickle cell anemia, but little information exists regarding the safety of maximal cardiopulmonary exercise testing (CPET) or the mechanisms of exercise limitation in these patients. The purpose of the present study was to examine these issues. Seventeen adult women with sickle cell anemia underwent symptom-limited maximal CPET using cycle ergometry and ramp protocols; blood gases and lactate concentrations were measured every 2 minutes. All patients completed CPET without complications. No patient demonstrated a mechanical ventilatory limitation to exercise or had evidence of myocardial ischemia. However, we observed three pathophysiologic patterns of response to exercise in these patients. Eleven patients had low peak VO2, low anaerobic threshold (AT), gas exchange abnormalities, and high ventilatory reserve; this pattern is consistent with exercise limitation due to pulmonary vascular disease in this patient subgroup. Three patients had low peak VO2, low AT, no gas exchange abnormalities, and a high heart rate reserve, a pattern consistent with peripheral vascular disease and/or a myopathy. The remaining three patients had low peak VO2, low AT, no gas exchan...Continue Reading

References

Jan 1, 1978·Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology·R D WoodsonC Lenfant
Jun 1, 1992·Anesthesiology·J W Severinghaus, J F Kelleher
Jul 15, 1991·Annals of Internal Medicine·J Valeriano-Marcet, L D Kerr
Feb 1, 1990·Seminars in Arthritis and Rheumatism·H R SchumacherM K Dalinka
Sep 24, 1987·The New England Journal of Medicine·J A KarkC J Ruehle
Feb 1, 1983·The American Journal of Cardiology·W CovitzR H DuRant
Nov 1, 1984·American Journal of Diseases of Children·B S AlpertW Covitz
Sep 1, 1980·Transfusion·H G KleinR M Winslow
Jun 9, 1994·The New England Journal of Medicine·O S PlattP P Klug
Nov 1, 1993·The American Journal of Medicine·S Mani, T P Duffy
Jun 1, 1993·Archives of Disease in Childhood·P PianosiA L Coates
Jul 1, 1993·European Journal of Clinical Investigation·N P LewisA H Henderson
May 1, 1993·The American Journal of the Medical Sciences·J Haynes, M B Kirkpatrick
Dec 1, 1996·Hematology/oncology Clinics of North America·E Vichinsky, L Styles
Dec 23, 1998·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J N AdlerC A Camargo
Feb 2, 1999·American Journal of Respiratory and Critical Care Medicine·F O OrtizL J Benjamin
May 6, 1999·American Journal of Respiratory and Critical Care Medicine·Mark T GladwinF P Ognibene
Feb 1, 1960·The Journal of Clinical Investigation·B J SPROULEW F MILLER

Citations

May 7, 2008·Journal of Pediatric Hematology/oncology·Bibhuti B DasAshok Raj
Aug 28, 2012·Chest·Rifat A ChaudrySuzanne Crowley
Nov 24, 2005·Chest·Christophe DelclauxFrédéric Galactéros
Mar 16, 2011·Revue des maladies respiratoires·B MaîtreFrédéric Galactéros
May 17, 2011·British Journal of Haematology·Edwige Balayssac-SiransyPascal Bogui
May 7, 2014·American Journal of Hematology·Eduard J van BeersPaul Bresser
Mar 17, 2015·The American Journal of Pathology·Marion RavelojaonaLaurent A Messonnier
Mar 24, 2012·Journal of the American College of Cardiology·Mark T Gladwin, Vandana Sachdev
Dec 6, 2014·The Journal of Pediatrics·Anthony M AlvaradoRobert I Liem
Oct 16, 2016·Journal of Tropical Medicine·Adedoyin DosunmuSarah John-Olabode
Sep 27, 2016·International Journal of Dermatology·Hojjat AfradiShahram Teimourian
Mar 25, 2017·Blood Cells, Molecules & Diseases·Berenike MöckeschSophie Antoine-Jonville
Jun 10, 2017·Pediatric Blood & Cancer·Robert I LiemAlexis A Thompson
Sep 22, 2007·The Clinical Journal of Pain·Jennifer PellsLesco Rogers
Mar 29, 2019·Medicine and Science in Sports and Exercise·Laurent A MessonnierLéonard Féasson
Jul 19, 2020·American Journal of Hematology·Angèle N MerletEXDRE collaborative study group
Apr 28, 2019·Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses·Suzanne AmeringerEdmund O Acevedo
Dec 4, 2020·Journal of Applied Physiology·Laurent A MessonnierLéonard Féasson
Aug 11, 2018·Medicine and Science in Sports and Exercise·Angèle N MerletLaurent A Messonnier

Related Concepts

Anemia, Sickle Cell
Cardiopulmonary Exercise Test
Oxygen Consumption
Pulmonary Gas Exchange
Expiratory Airflow
Safety
Exercise Tolerance
Lactate

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