Table 1. Studies analysing the aerobic fitness of patients with chronic hepatitis B: methodology and results.
|
1 st author (ref) |
Alameri 20 |
Galant 21 |
Galant 2 |
Faustini Pereira 3 |
|
Study duration |
.12 months |
.5 months |
.5 months |
.3 years |
|
City (Country) |
.Riyad (Saudi Arabia) |
.Porto Alegre (Brazil) |
.Porto Alegre (Brazil) |
.Porto Alegre (Brazil) |
|
Main aims |
.To compare the 6MWD of healthy participants and patients with hepatic pathologies .To study the correlations between the 6MWD and certain clinical and biochemical markers of the disease |
.To assess the correlation between O2peak, and respiratory muscle strength and QOL in patients with hepatic cirrhosis |
.To compare the muscle strength, exercise capacity and QOL data of 3 groups of patients with cirrhosis |
.To evaluate the relationship between the 6MWD, MIP, O2peak and the survival rate of patients with cirrhosis |
|
Study design |
.Prospective study |
.Cross-sectional study |
.Cross-sectional study |
.Prospective study |
|
Sample (M/F) |
.250 (150/100) |
.26 (14/12) |
.86 (64/22) |
.86 (66/20) |
|
Populations |
4 groups .GA: 45 (22 M) healthy .GB: 49 (22 M) CHB .GC: 58 (42 M) CHC .GD: 98 (64 M) cirrhosis |
3 groups (cirrhosis) .GA: 2 post-CHB .GB: 16 post-CHC .GC: 8 post-alcohol |
3 groups (cirrhosis) .GA: 40 (30 M) post-CHC .GB: 14 (10 M) post-CHB .GC: 32 (20 M) post-alcohol |
3 groups (cirrhosis) .GA: 40 post-CHC .GB: 16 post-CHB .GC: 30 post-alcohol |
|
Characteristics of patients with CHB |
.Ag HBs+ .ALT: normal or increased .Bilirubin, albumin, INR: normal .CBC: normal .Abdominal echography: normal .No PH or cirrhosis |
.NR |
.NR |
.No systemic disease .No co-infection .No chronic disease |
|
Age (years) |
GB: 18-80 a , 38±12 b |
.TS: 53±9 b |
GB: 52±6 b |
.< 65, TS: 56±8 b |
|
Height (m) |
.NR |
.NR |
GB: 1.69±0.73 b |
.TS: 1.67±0.83 b |
|
Weight (kg) |
.NR |
.NR |
GB: 69±11 b |
.TS: 67±9 b |
|
BMI (kg/m 2 ) |
.GB: 33.3±20.6 c |
.TS: 25.4±2.25 c |
.TS: 24.10±1.21 b |
|
|
Applied tests (main collected data) | ||||
|
Deficiency |
.NA |
.Respiratory muscle strength: MIP/MEP (cmH2O) |
.Spirometric data: FEV1, FVC .Respiratory muscle strength: MIP/MEP (cmH2O) |
.Respiratory muscle strength: MIP/MEP (cmH2O) |
|
Incapacity |
.6MWT: 6MWD (m), HR (bpm), oxy-sat (%), dyspnoea (Borg scale) |
.CPET: O2peak (mL/min/kg), dyspnoea (Borg scale) |
.6MWT: 6MWD (m), HR (bpm), oxy-sat (%), RR (cpm), dyspnoea (Borg scale) |
.6MWT: 6MWD (m), oxy-sat (%), HR (bpm) .CPET: O2peak (mL/min/kg) |
|
Social disadvantage |
.NA |
.QOL: SF-36 |
.QOL: SF-36 |
.NA |
|
Other data |
.Biological data (ALT, AST, GGT, AP, haemoglobin, albumin, bilirubin, creatinine) |
.MELD: disease severity score |
.MELD: disease severity score |
.Survival rate |
|
Main results | ||||
|
Deficiency |
.NA |
.MIP: 73±22b .MEP:79±29b |
.MIP: GA: 82±14b, GB: 72±7b, GC: 66±11b .MEP: GA: 83±12b, GB: 82±14b, GC: 65±11b .FEV1 (%): GA: 91±17b, GB: 89±18b, GC: 87±14b .FVC (%): .GA: 95±19b, GB: 97±17b, GC: 93±30b |
.MIP: =70±14c, < 70: SRof 62%, � 70: SRof 93%, AUC ROC, sensibility and specificity: 0.69/71%/53%, SR 18% more higher with MIP increase |
|
Incapacity |
.6MWD: GA: 421±47b, GB: 390±53b, GC: 357±72b GD: 306±111b .HRend (bpm): GB: 86±13b .Oxy-satend (%): GB: 98.2±0.76b .Dyspnoeaend:GB: 0.53±0.73b |
.O2peak: 17.01±5.91 b |
.6MWD: GA: 476±29b, GB: 464±32b, GC: 373±50b .HRrest (bpm): GB: 77±11b .HRend (bpm): GB: 91±15b .RRrest (cpm): GB: 15±3b .RRend (cpm): GB: 21±3b .Oxy-satrest (%): GB: 98±1b .Oxy-satend (%): GB: 97±1b .Dyspnoearest: GB: 1±0,6b .Dyspnoeaend: GB: 2±1b |
.6MWD: 410±29b, < 410: SRof 55%, � 410: SRof 97%, AUCROC, sensibility and specificity: 0.87/92%/31%, SR 20% more higher with 6MWD increase .O2peak: =17.06c, < 17: SRof 55%, �17: SRof 94%, AUCROC, sensibility and specificity: 0.78/87%/41%, SR 30% more higher with O2pic increase |
|
Social disadvantage |
.NA |
.SF-1=47±26 b , SF-2=35±38 b , SF-3=49±24 b , SF-4=42±18 b , SF-5=48±28 b , SF-6=61±31 b , SF-7=51±42 b , SF-8=58±30 b |
.SF-1=65±22 b , SF-2=65±21 b , SF-3=61±26 b , SF-4=52±18 b , SF-5=63±26 b SF-6=71±25 b , SF-7=52±15 b , SF-8=68±16 b |
.NA |
|
Other results |
6MWD correlated with .Age (r=-0.482) .Height (r=0.281) .Dyspnoea [rest (r=-0.518), end (-0.581)] .Haemoglobin (r=0.373) .Albumin (r=0.311) |
O2peakcorrelated with: .MIP (r=0.64) .MELD (r=0.91) |
6MWD correlated with: .MELD (r=-0.56) |
Mortality .GA: 3 .GB: 5 .GC: 11 |
|
Conclusion |
.The 6MWT is useful for assessing the physical capacity of patients with chronic liver disease. |
.There is a correlation between theO2peak and MIP. .Patients have poor QOL |
.Compared to patients with cirrhosis post-alcoholic, those with cirrhosis post-CHB have better respiratory muscle strength, better exercise capacity, and better QOL. |
.6MWD, MIP, O2peak: predictors of mortality in patients with cirrhosis |
|
ALT: alanine-aminotransferase. AP: alkaline-phosphatase. AST: aspartate-aminotransferase. AUC: Area-under-the-curve. CBC: chronic-hepatitis B. CBC: complete-blood-count. CHC: chronic-hepatitis c. CPET: cardiopulmonary-exercise-test. end : end of the 6MWT. F: female. FEV 1 : forced expiratory-volume-in-one-second. FVC: forced-vital-capacity. G: group. GGT: gamma-glutamyltranspeptidase.HR: heart-rate. INR: international-normalized-ratio. M: male. MELD: disease-severity-score. MEP: maximal-expiratory-pressure. MIP: maximal-inspiratory-pressure. NA: non-applied. NR: non-reported. Oxy-sat: oxygen haemoglobin saturation. PH: portal-hypertension. QOL: quality-of-life. r: coefficient of correlation. rest : at rest before the 6MWT. ROC: receiver-operating-characteristic. RR: respiratory-rate. SF-1: functional-capacity.SF-2: limited by the physical aspect. SF-3: pain. SF-36: short form-36. SF-4: general health. SF-5: vitality.SF-6: social. SF-7: mental health. SF-8: limitation by emotional aspects. SR: survival rate. TS: total-sample. O2peak: peak of oxygen consumption. 6MWD: 6-min-walk-distance.6MWT: 6-min-walk-test. Date were expressed: a Minimum-maximum; b Mean±standar-deviation, c Mean. Study of Alameri: GB: younger than GC or GD 6MWD of GB: lower than this of GA, higher than these of GC and GD Study of Galant-2012: FEV 1 and FVC of GB: similar to other 2 groups MIP and MEP of GB: higher than these of GC. 6MWD of GB: higher than this of GC. HR end of GB: lower than this of GC. Dyspnoea end of GB: lower than this of GC. SF-1 and SF-2 scores of GB: higher than these of GC. | ||||