학술논문
Cardiac diastolic maladaptation is associated with the severity of exercise intolerance in sickle cell anemia patients.
Document Type
Academic Journal
Author
d'Humières T; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France. Thomas.dhumieres@aphp.fr.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France. Thomas.dhumieres@aphp.fr.; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France. Thomas.dhumieres@aphp.fr.; Bouvarel A; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Boyer L; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Savale L; Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France.; School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.; Guillet H; Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France.; Alassaad L; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; de Luna G; Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France.; Berti E; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Iles S; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Pham Hung d'Alexandry d'Orengiani AL; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France.; Audureau E; Biostatistics Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; CEpiA IMRB U955, FHU SENEC, Université Paris Est (UPEC), Créteil, France.; Troupe MJ; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Schlatter RC; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Lamadieu A; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Galactéros F; Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France.; Derumeaux G; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France.; INSERM IMRB U955, Université Paris Est (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.; Messonnier LA; Inter-University Laboratory of Human Movement Sciences EA 7424, Université Savoie Mont Blanc, Chambéry, France.; Bartolucci P; Department of Internal Medicine, Henri-Mondor University Hospital-UPEC/Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, FHU SENEC, CHU Henri Mondor APHP, Créteil, France.
Source
Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
Subject
Language
English
Abstract
This pilot study focusing on Sickle Cell Anemia (SCA) patients offers a comprehensive and integrative evaluation of respiratory, cardiovascular, hemodynamic, and metabolic variables during exercise. Knowing that diastolic dysfunction is frequent in this population, we hypothesize that a lack of cardiac adaptation through exercise might lead to premature increase in blood lactate concentrations in SCA patients, a potential trigger for acute disease complication. SCA patients were prospectively included in PHYSIO-EXDRE study and underwent a comprehensive stress test with a standardized incremental exercise protocol up to 4 mmol L -1 blood lactate concentration (BL4). Gas exchange, capillary lactate concentration and echocardiography were performed at baseline, during stress test (at ∼ 2 mmol L -1 ) and BL4. The population was divided into two groups and compared according to the median value of percentage of theoretical peak oxygen uptake (% V ˙ O 2 p e a k t h ) at BL4. Twenty-nine patients were included (42 ± 12 years old, 48% of women). Most patients reached BL4 at low-intensity exercise [median value of predicted power output (W) was 37%], which corresponds to daily life activities. The median value of % V ˙ O 2 p e a k t h at BL4 was 39%. Interestingly, diastolic maladaptation using echocardiography during stress test along with hemoglobin concentration were independently associated to early occurrence of BL4. As BL4 occurs for low-intensity exercises, SCA patients may be subject to acidosis-related complications even during their daily life activities. Beyond assessing physical capacities, our study underlines that diastolic maladaptation during exercise is associated with an early increase in blood lactate concentration.
(© 2024. The Author(s).)
(© 2024. The Author(s).)