Source: Annual Congress 2002 - Asbestos and silica

Abstract

Cardiopulmonary exercise testing (CPX) is important in the assessment of impairment/disability in occupational lung diseases. Nevertheless, few studies are able to establish the correlation among pulmonary function tests (PFT), exercise and radiographic (XR) abnormalities in patients with silicosis.
AIMS: To evaluate the response to CPX in patients with silicosis, and to assess its relationship between XR and PFT changes.
METHODS: We studied 29 silica-exposed men (mean age=45.5 years old) with XR, complete PFT and CPX. The CPX were performed on a cycle ergometer, after 3 min of unloading cycling, with 25 W/min increment of power. XR were classified into a 5-point score (normal (n=5), category I (n=5), II (n=5), III (n=5) and large opacities (n=9)), according to ILO/1980.
RESULTS: The XR score correlated with maximal oxygen uptake % predicted (VO2max%): Spearman r= -0.55* and dead space-to-tidal volume ratio (VD/VT): rS= 0.58*. The correlations between selected PFT and CPX values are shown below:

Pearson r	FVC (%)	FEV1 (%)	FVC/FEV1	RV/TLC	DLCO/VA
VO2max%	0.40*	0.49*	0.47*	-0.47*	0.36
VD/VT	-0.21	-0.41*	-0.55*	0.57*	-0.54*
P(A-a)O2	-0.45*	-0.41*	-0.21	0.36	-0.05

*p<0.05
CONCLUSIONS: The low values of VO2max may result from reduced O2 transport and utilization. The high VD/VT ratio, which correlated with XR score, is likely the result of many factors, including ventilation-perfusion mismatch and a shallow breathing pattern. However, it may be inaccurate to predict exercise capacity from resting PFT, since we didn't find strong correlations between their values in this population. Thus, it is always advisable to perform CPX tests in the evaluation of silicotic patients.

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V. C. S. Antao, G. A. Pinheiro, A. J. Lopes, J. M. Jansen (Rio de Janeiro, Brazil). Cardiopulmonary exercise testing in silicosis: comparison to functional and radiological findings. Eur Respir J 2002; 20: Suppl. 38, 853

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