Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.

Cystic fibrosis (CF) is a debilitating chronic condition, which requires complex and expensive disease management. Exercise has now been recognised as a critical factor in improving health and quality of life in patients with CF. Hence, cardiopulmonary exercise testing (CPET) is used to determine ae...

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Main Authors: Craig A Williams, Kyle C A Wedgwood, Hossein Mohammadi, Katie Prouse, Owen W Tomlinson, Krasimira Tsaneva-Atanasova
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0211219
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spelling doaj-1a03b3421bb345c98ea9ef873e9debfd2021-03-04T12:39:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01142e021121910.1371/journal.pone.0211219Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.Craig A WilliamsKyle C A WedgwoodHossein MohammadiKatie ProuseOwen W TomlinsonKrasimira Tsaneva-AtanasovaCystic fibrosis (CF) is a debilitating chronic condition, which requires complex and expensive disease management. Exercise has now been recognised as a critical factor in improving health and quality of life in patients with CF. Hence, cardiopulmonary exercise testing (CPET) is used to determine aerobic fitness of young patients as part of the clinical management of CF. However, at present there is a lack of conclusive evidence for one limiting system of aerobic fitness for CF patients at individual patient level. Here, we perform detailed data analysis that allows us to identify important systems-level factors that affect aerobic fitness. We use patients' data and principal component analysis to confirm the dependence of CPET performance on variables associated with ventilation and metabolic rates of oxygen consumption. We find that the time at which participants cross the gas exchange threshold (GET) is well correlated with their overall performance. Furthermore, we propose a predictive modelling framework that captures the relationship between ventilatory dynamics, lung capacity and function and performance in CPET within a group of children and adolescents with CF. Specifically, we show that using Gaussian processes (GP) we can predict GET at the individual patient level with reasonable accuracy given the small sample size of the available group of patients. We conclude by presenting an example and future perspectives for improving and extending the proposed framework. The modelling and analysis have the potential to pave the way to designing personalised exercise programmes that are tailored to specific individual needs relative to patient's treatment therapies.https://doi.org/10.1371/journal.pone.0211219
collection DOAJ
language English
format Article
sources DOAJ
author Craig A Williams
Kyle C A Wedgwood
Hossein Mohammadi
Katie Prouse
Owen W Tomlinson
Krasimira Tsaneva-Atanasova
spellingShingle Craig A Williams
Kyle C A Wedgwood
Hossein Mohammadi
Katie Prouse
Owen W Tomlinson
Krasimira Tsaneva-Atanasova
Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
PLoS ONE
author_facet Craig A Williams
Kyle C A Wedgwood
Hossein Mohammadi
Katie Prouse
Owen W Tomlinson
Krasimira Tsaneva-Atanasova
author_sort Craig A Williams
title Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
title_short Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
title_full Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
title_fullStr Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
title_full_unstemmed Cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
title_sort cardiopulmonary responses to maximal aerobic exercise in patients with cystic fibrosis.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2019-01-01
description Cystic fibrosis (CF) is a debilitating chronic condition, which requires complex and expensive disease management. Exercise has now been recognised as a critical factor in improving health and quality of life in patients with CF. Hence, cardiopulmonary exercise testing (CPET) is used to determine aerobic fitness of young patients as part of the clinical management of CF. However, at present there is a lack of conclusive evidence for one limiting system of aerobic fitness for CF patients at individual patient level. Here, we perform detailed data analysis that allows us to identify important systems-level factors that affect aerobic fitness. We use patients' data and principal component analysis to confirm the dependence of CPET performance on variables associated with ventilation and metabolic rates of oxygen consumption. We find that the time at which participants cross the gas exchange threshold (GET) is well correlated with their overall performance. Furthermore, we propose a predictive modelling framework that captures the relationship between ventilatory dynamics, lung capacity and function and performance in CPET within a group of children and adolescents with CF. Specifically, we show that using Gaussian processes (GP) we can predict GET at the individual patient level with reasonable accuracy given the small sample size of the available group of patients. We conclude by presenting an example and future perspectives for improving and extending the proposed framework. The modelling and analysis have the potential to pave the way to designing personalised exercise programmes that are tailored to specific individual needs relative to patient's treatment therapies.
url https://doi.org/10.1371/journal.pone.0211219
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