Cardiopulmonary testing in adult patients with β-thalassemia major in comparison to healthy subjects.

β-Thalassemia patients often have a reduced capacity of exercise and abnormal respiratory function parameters, but the reasons are unclear. In order to identify the causes of the exercise limitation, we performed a cardiopulmonary exercise testing (CPET) in a group of 54 adult β-thalassemia major (T...

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Publicado en:Annals of Hematology Vol. 101; no. 11; pp. 2445 - 2453
Autores principales: Piatti, G., Giuditta, M., Consonni, D., Cassinerio, E., Cappellini, M. D.
Formato: Journal Article
Publicado: Springer Nature Nov2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2022
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00277-022-04974-w
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        atl: Cardiopulmonary testing in adult patients with β-thalassemia major in comparison to healthy subjects.
      aug:
        au:
          Piatti, G.
          Giuditta, M.
          Consonni, D.
          Cassinerio, E.
          Cappellini, M. D.
        affil: Department of Pathophysiology and Transplantation, University of Milan and Bronchopneumology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
      sug:
        subj:
          beta-Thalassemia Therapy
          Exercise Tolerance
          Oxygen
          Quality of Life
          Exercise Test Methods
          Research Subjects
          Oxygen Consumption
          Adult
          Iron
          Clinical Assessment Tools
          Ferrans and Powers Quality of Life Index
          Questionnaires
          Exercise of Self-Care Agency Scale
          Adult: 19-44 years
      ab: β-Thalassemia patients often have a reduced capacity of exercise and abnormal respiratory function parameters, but the reasons are unclear. In order to identify the causes of the exercise limitation, we performed a cardiopulmonary exercise testing (CPET) in a group of 54 adult β-thalassemia major (TM) patients without pulmonary arterial hypertension and in a group of healthy control subjects. All subjects underwent cardiac echocardiography and carried out pulmonary function tests. TM patients also filled an IPAQ questionnaire on usual physical activity (PA).Overall, TM patients have a diminished exercise performance in comparison to control subjects. In fact, peak oxygen uptake (V'O2 peak), expressing maximum exercise capacity, was decreased in 81.5% of the patients; similarly, anaerobic threshold (V'O2@AT) and O2 pulse also resulted lowered. In multivariable regression models adjusted for gender, age, BMI, and mean haemoglobin, V'O2 peak and O2 pulse were positively associated with cardiac iron overload (T2*). No ventilatory limitation to exercise was observed. The most important causes of exercise limitation in these patients were muscular deconditioning and reduced cardiac inotropism due to iron deposition. Only 15/54 (27.8%) TM patients used to perform vigorous physical activity. These results suggest that a program of regular physical activity may be useful to increase the tolerance to effort and therefore to improve the quality of life in these patients.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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