Rising stars of DPLD survival: FVC and exercise desaturation (a single-center study)

Turk J Med Sci. 2018 Aug 16;48(4):826-832. doi: 10.3906/sag-1802-196.

Abstract

Background/aim: Diffuse parenchymal lung diseases (DPLDs) comprise a broad, heterogeneous group of diseases with common functional characteristics and a common final pathway, usually leading to irreversible fibrosis. We investigated the effects of the physiological and functional parameters and of pulmonary hypertension (PH) on survival in DPLDs.

Materials and methods: The study included 158 patients with DPLDs. Patient data were examined retrospectively, and survival status was obtained through phone calls.

Results: Patients were divided into five groups according to their diagnosis: idiopathic pulmonary fibrosis (IPF), non-IPF idiopathic interstitial pneumonias, connective tissue diseases, sarcoidosis, and other DPLDs. Median survival was 42.9 months. The significant negative effects of older age, presence of delta saturation (DeltaSat; difference between oxygen saturation at rest and after the 6-min walking test), 6-min walking distance (<350 m), systolic pulmonary artery pressure (sPAP; ≥50 mmHg), and baseline percentage of diffusing capacity of the lungs for carbon monoxide (<80%) with percentage of forced vital capacity (FVC%; <80%) were detected on survival (P < 0.05). A one-unit decrease in FVC% was related to a 6% increase in mortality. Another unique finding indicated that higher DeltaSat (>10%) correlated strongly with sPAP (>50 mmHg) and thus with a worse survival rate.

Conclusion: The current study determined that FVC% is important in the prediction of mortality. Moreover, it demonstrated a strong relationship between exercise desaturation and PH.

Keywords: Desaturation; diffuse parenchymal lung diseases; forced vital capacity; survival; pulmonary hypertension.

MeSH terms

  • Age Factors
  • Aged
  • Blood Pressure
  • Carbon Monoxide / metabolism*
  • Connective Tissue Diseases / metabolism
  • Connective Tissue Diseases / mortality
  • Connective Tissue Diseases / physiopathology
  • Exercise / physiology*
  • Exercise Test
  • Female
  • Fibrosis
  • Humans
  • Hydrogen-Ion Concentration
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / mortality
  • Idiopathic Pulmonary Fibrosis / metabolism
  • Idiopathic Pulmonary Fibrosis / mortality
  • Idiopathic Pulmonary Fibrosis / physiopathology
  • Lung / physiopathology*
  • Lung Diseases / metabolism
  • Lung Diseases / mortality*
  • Lung Diseases / physiopathology
  • Lung Diseases, Interstitial / metabolism
  • Lung Diseases, Interstitial / mortality
  • Lung Diseases, Interstitial / physiopathology
  • Male
  • Middle Aged
  • Oxygen / metabolism*
  • Oxygen Consumption
  • Rest
  • Retrospective Studies
  • Sarcoidosis / metabolism
  • Sarcoidosis / mortality
  • Sarcoidosis / physiopathology
  • Survival Analysis
  • Vital Capacity*
  • Walking

Substances

  • Carbon Monoxide
  • Oxygen