Thin-Section CT Abnormalities and Pulmonary Gas Exchange Impairment in Workers Exposed to Asbestos

Sette, A; Neder, J. Alberto; Nery, Luíz Eduardo; Kavakama, Jorge; Rodrigues, Reinaldo T; Filho, Mário Terra; Guimarães, Sandra; Bagatin, Ericson; Müller, Néstor L.

doi:10.1148/radiol.2321030392

Cited by 27 publications

(17 citation statements)

References 32 publications

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“…, Smith and Agostoni , Shih et al . and Sette et al ., we observed an increase of P(A‐a)O 2 during exercise. There was a significant positive correlation with the severity of asbestos disease (r = 0.747; P < 0.001).…”

Section: Discussionsupporting

confidence: 48%

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Spiroergometric parameters at maximal exercise testing assessed functional respiratory impairment in asbestos‐induced fibrosis

Schneider

Arhelger

Funk

2013

Clinical Respiratory J

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Section: Discussionsupporting

confidence: 48%

“…A high cumulative dose confirms the diagnosis of asbestosis in patients suffering from pulmonary fibrosis. Pulmonary limitations in patients with asbestosis show better correlation to the stage of morphologic alterations detected in chest radiography than to those found by advanced imaging modalities such as high‐resolution CT .…”

Section: Discussionmentioning

confidence: 93%

Spiroergometric parameters at maximal exercise testing assessed functional respiratory impairment in asbestos‐induced fibrosis

Schneider

Arhelger

Funk

2013

Clinical Respiratory J

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“…In fact, there might be more derangement in oxygen transport on exertion in patients whose disease is characterised by a greater degree of interstitial fibrosis. This hypothesis is supported by the relationships observed between exercise-induced desaturation and the profusion and extent of parenchymal abnormality on imaging [41]. Reduced mixed venous oxygen content is also seen in exercising ILD patients, possibly due to reduced cardiac output, arterial oxygen content and proportionally increased extraction of oxygen by working muscles [37].…”

Section: Impaired Gas Exchangementioning

confidence: 76%

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

Bonini

Fiorenzano

2017

Eur Respir Rev

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Interstitial lung diseases (ILDs) represent a heterogeneous group of pathologies characterised by alveolar and interstitial damage, pulmonary inflammation (usually associated with fibrosis), decreased lung function and impaired gas exchange, which can be attributed to either a known or an unknown aetiology. Dyspnoea is one of the most common and disabling symptoms in patients with ILD, significantly impacting quality of life. The mechanisms causing dyspnoea are complex and not yet fully understood. However, it is recognised that dyspnoea occurs when there is an imbalance between the central respiratory efferent drive and the response of the respiratory musculature. The respiratory derangement observed in ILD patients at rest is even more evident during exercise. Pathophysiological mechanisms responsible for exertional dyspnoea and reduced exercise tolerance include altered respiratory mechanics, impaired gas exchange, cardiovascular abnormalities and peripheral muscle dysfunction.This review describes the respiratory physiology of ILD, both at rest and during exercise, and aims to provide comprehensive and updated evidence on the clinical utility of the cardiopulmonary exercise test in the assessment and management of these pathological entities. In addition, the role of exercise training and pulmonary rehabilitation programmes in the ILD population is addressed.

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“…This hypothesis is supported by the relationships between exerciseinduced desaturation and the profusion and extent of parenchymal abnormality on imaging. 14,15 Circulatory limitation also plays an important role in exercise limitation. In patients with ILD and a variety of diagnoses, the peak oxygen uptake (VO 2 ) correlated better with measures of circulatory impairment than with measures of ventilatory or gas exchange impairment.…”

Section: Mechanisms Of Exercise Limitation In Ildmentioning

confidence: 99%

Review series: Aspects of interstitial lung disease: Exercise limitation in interstitial lung disease - mechanisms, significance and therapeutic options

2010

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Exercise limitation is a cardinal feature of the interstitial lung diseases and is frequently associated with marked dyspnoea on exertion. People with interstitial lung disease exhibit a rapid, shallow breathing pattern during exercise that worsens as disease progresses. Despite this, ventilatory mechanics are not the major limitation to exercise in most patients, with impaired gas exchange and circulatory limitation playing a more important role. Peripheral and respiratory muscle dysfunction may also contribute to impaired exercise tolerance, either due to systemic manifestations of the underlying disease, treatment side-effects or deconditioning. Measures of exercise capacity or desaturation obtained from maximal and submaximal exercise tests are good predictors of survival in patients with idiopathic pulmonary fibrosis. However, to date few pharmaceutical treatments have affected exercise outcomes despite improvements in other important clinical markers. Supplemental oxygen acutely improves exercise capacity in interstitial lung disease and is recommended for hypoxic patients, although quality of life or survival benefits have not yet been demonstrated. Exercise training improves walking capacity and dyspnoea in short-term trials and is useful to maximize functional capacity. The role of exercise testing in the routine management of patients with interstitial lung disease is not clearly defined. However, given the poor prognosis in patients with idiopathic pulmonary fibrosis and the marked variation in clinical course, assessment of exercise capacity may provide useful information for both clinicians and patients when evaluating the risks and benefits of new treatments. The extent of resting or exercise-induced hypoxia in patients with interstitial lung disease may influence the selection of an appropriate exercise test, and oxygen administration should be standardized on repeat testing.

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Thin-Section CT Abnormalities and Pulmonary Gas Exchange Impairment in Workers Exposed to Asbestos

Abstract: Thin-section CT grading of interstitial lung disease is useful in assessing the likelihood of pulmonary gas exchange impairment at rest (Dlco) and during exercise (DeltaP[A-a]O(2)/VO(2)) in workers with long-term asbestos exposure.

Cited by 27 publications

References 32 publications

Spiroergometric parameters at maximal exercise testing assessed functional respiratory impairment in asbestos‐induced fibrosis

Spiroergometric parameters at maximal exercise testing assessed functional respiratory impairment in asbestos‐induced fibrosis

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

Review series: Aspects of interstitial lung disease: Exercise limitation in interstitial lung disease - mechanisms, significance and therapeutic options

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