Author:
d’Humières Thomas,Bouvarel Antoine,Boyer Laurent,Savale Laurent,Guillet Henri,Alassaad Lara,de Luna Gonzalo,Berti Enora,Iles Sihem,Pham Hung d’Alexandry d’Orengiani Anne Laure,Audureau Etienne,Troupe Marie-Joelle,Schlatter Reine-Claude,Lamadieu Anaïs,Galactéros Frédéric,Derumeaux Geneviève,Messonnier Laurent A.,Bartolucci Pablo
Abstract
AbstractThis 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 (%$${\dot{\text{V}}\text{O}}_{2peakth}$$
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) 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 %$${\dot{\text{V}}\text{O}}_{2peakth}$$
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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.
Publisher
Springer Science and Business Media LLC
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