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High prevalence of known and unknown pulmonary diseases in patients with claudication during exercise oximetry: A retrospective analysis. | LitMetric

High prevalence of known and unknown pulmonary diseases in patients with claudication during exercise oximetry: A retrospective analysis.

Medicine (Baltimore)

Department of Sports Medicine and Vascular Investigations, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, France Ecole supérieure d'électronique de l'Ouest, Institute of Science & Technology, France LAUM-UMR CNR6613, France Department of Pneumology, University Hospital of Angers, Univ. Angers, Université Bretagne Loire, INSERM 1063, France Mitovasc, UMR INSERM 1083/CNRS 6214, Univ. Angers, Université Bretagne Loire, Angers, France.

Published: October 2016

AI Article Synopsis

  • Recent research indicates that about 20% of patients with peripheral artery disease (PAD) exhibit abnormal oxygen levels during exercise, which may lead to walking difficulties due to low oxygen (hypoxemia).
  • The study reviewed the medical records of 1482 patients, finding that 158 had suspected unknown pulmonary disease, with many not following up with a pulmonologist; 93% of those who did get further evaluation were diagnosed with pulmonary issues.
  • Out of 47 patients who underwent further walking evaluations after treatment for pulmonary disorders, those who received treatment showed a significant improvement in their walking distance, indicating the importance of addressing these pulmonary issues in PAD patients.

Article Abstract

The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease. The second aim of this study was to evaluate the impact of the therapeutic interventions on the walking capacities, after treatment, of the eventually detected pulmonary disorders.We retrospectively analyzed 1482 exercise TcpO2 test results. Patients that had no history of pulmonary disease, but either reported severe dyspnea or showed atypical profiles on their chest exercise-TcpO2, were advised to refer to the department of pneumology for additional investigations.In addition to the 166 patients with a history of pulmonary disease, 158 patients were suspected of unknown pulmonary disease from the result of their TcpO2 test. Many patients (n = 99/158, 62.7%) did not attend a pulmonologist visit. A pulmonary disease was established in 55 (93.2%) of the other 59 patients. Obstructive sleep apnea syndrome (OSAS) was the one and only diagnosis retained in 42/59 patients (71.2%). Among the 47 patients who had a second evaluation of their walking capacity on treadmill, 38 had treatment of the pulmonary disease found, vascular surgery treatment or a severe restricted diet, 9 had no treatment. Only the "treated" group showed a significant improvement in the maximal walking distance on treadmill between the 2 evaluations, 313 ± 251 m to 433 ± 317 m (P = 0.03).This retrospective pilot study underlines the high prevalence of both known and unknown pulmonary disease in patients whose primary complaint was lower limb claudication. Systematic screening and treatment of pulmonary disease in patients with claudication might be justified, to improve walking ability of such patients and possibly reduce or delay the requirement for revascularization. Prospective studies are required to confirm these preliminary results.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059048PMC
http://dx.doi.org/10.1097/MD.0000000000004888DOI Listing

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