Incremental step test in patients with pulmonary hypertension

Vieira, Elaine Brito; Ramos, Roberta Pulcheri; Ivanaga, Ivan; Rolim, João Victor; Fonseca, Angelo C.X.; Júnior, José Rodrigues; Ferreira, Eloara Vieira Machado; Corso, Simone Dal; Nery, Luíz Eduardo; Ota-­Arakaki, Jaquelina Sonoe; Loureiro, Camila Melo Coelho

doi:10.1183/13993003.congress-2018.pa2463

Cited by 2 publications

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“…Another study done in patients with a perfusion defect was by Vieira et al, who looked at the usefulness of the IST in 20 patients with pulmonary hypertension [43]. They found a high correlation between desaturation levels on the IST and CPET in patients walking on a treadmill: in the CPET, SpO2 fell from 96% (SD3) to 92% (SD 6); in the IST it fell from 96% (SD 3) to 89% (SD 8) -a difference that was not statistically signi cant but which may have been clinically signi cant.…”

Section: Validation Of Tests For Exertional Hypoxia In Conditions Othmentioning

confidence: 99%

What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review 

Kalin

Javid

Knight

et al. 2020

Preprint

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BackgroundEven when resting pulse oximetry is normal in the patient with acute Covid-19, hypoxia can manifest on exertion. We sought to summarise the literature on the performance of different rapid tests for exertional desaturation. Main research questionWhat tests have been formally evaluated for the rapid assessment of exertional hypoxia in patients with lung disease against a gold standard exercise test such as the 6MWT and CPET? MethodAMED, CINAHL, EMBASE MEDLINE, Cochrane and PubMed using LitCovid, Scholar and Google databases were searched to September 2020. Studies where participants had Covid-19 or another lung disease and underwent any form of exercise test which was compared to a reference standard were eligible. Risk of bias was assessed using QUADAS 2. Heterogeneity of study design precluded meta-analysis. ResultsOf 47 relevant papers, 15 were empirical studies, of which 11 described an attempt to validate one or more exercise desaturation tests in lung diseases other than Covid-19. In all but one of these, methodological quality was poor or impossible to fully assess. None had been designed as a formal validation study (most used simple tests of correlation). Only one validation study (comparing a 1-minute sit-to-stand test [1MSTST] with the reference standard 6-minute walk test [6MWT] in 107 patients with interstitial lung disease) contained sufficient raw data for us to calculate the sensitivity (88%), specificity (81%), and positive and negative predictive value (79% and 89% respectively) of the 1MSTST. The other 4 empirical studies included two predictive studies on patients with Covid-19, and two on HIV-positive patients with suspected pneumocystis pneumonia. We found no studies on the 40-step walk test (a less demanding test that is widely used in clinical practice to assess Covid-19 patients). DiscussionExertional desaturation tests have not yet been validated in patients with (or suspected of having) Covid-19. Whilst there is limited evidence for the diagnostic accuracy of the 1MSTST in other diseases, specific features of this disease (e.g. exertional hypoxia is common and many assessments are done remotely with no clinician present to resuscitate) may raise safety issues. The less strenuous 40-step walk test should be urgently evaluated.

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Section: Validation Of Tests For Exertional Hypoxia In Conditions Othmentioning

confidence: 99%

What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review 

Kalin

Javid

Knight

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In pneumology, a symptom-limited incremental step test has been previously shown to be well tolerated and reproducible in patients with COPD (19). In the work presented by Dr. Vieira et al, they investigated the use of a maximal symptom-limited cardiopulmonary incremental protocol on a single step in patients with pulmonary hypertension (PH) (20). To this end, the authors included twenty-one patients with PH which randomly performed a symptomlimited CPET on cycle ergometer (CYCLE) and IST.…”

Section: Usefulness Of Incremental Step Test In Patients With Pulmonamentioning

confidence: 99%

Clinical physiology and sleep: highlights from the European Respiratory Society Congress 2018 presented by early career members

Almendros

Aliverti

2018

J. Thorac. Dis.

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Incremental step test in patients with pulmonary hypertension

Cited by 2 publications

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What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review

What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review

Clinical physiology and sleep: highlights from the European Respiratory Society Congress 2018 presented by early career members

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Incremental step test in patients with pulmonary hypertension

Cited by 2 publications

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What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review&nbsp;

What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review&nbsp;

Clinical physiology and sleep: highlights from the European Respiratory Society Congress 2018 presented by early career members

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What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review

What is the Efficacy and Safety of Rapid Exercise Tests for Exertional Desaturation in Covid-19: A Rapid Systematic Review