Abstract
Exercise limitation in cirrhosis is typicallyattributed to a cirrhotic myopathy (without impairedoxygen utilization) and/or a cardiac chronotropicdysfunction. We performed symptom-limitedcardiopulmonary exercise testing in 19 cirrhotics withoutconfounding variables (cardiopulmonary disease, betablockade, anemia, smoking). Twelve concurrentlyexercised patients without cirrhosis and with normalresting pulmonary function were controls. Oxygenconsumption (Vo2) at peak exercise, atanaerobic threshold (Vo2-AT), workrate (WR),and heart rate (HR) were measured. Cirrhotics hadsignificantly lower peak WR (73 ± 4 vs 107 ± 7% predicted, p< 0.001), Vo2 (72 ± 4 vs 98± 5% predicted, P < 0.001), Vo2-AT(53 ± 4 vs 71 ± 5% predicted peakVo2, P < 0.01), HR (83 ± 2 vs 91± 2% predicted, P < 0.01) and were more likely to havechronotropic dysfunction (peak HR < 85% predicted).Six cirrhotics had normal aerobic capacity (peakVo2 > 80% predicted), while 13 wereabnormal. The abnormals had an earlier AT (46 ± 2 vs 67 ±3% predicted peak Vo2, P < 0.05) but nodifference in peak HR percent predicted was found. Inconclusion, two thirds of cirrhotics, withoutconfounding factors, have significantly reduced aerobic capacity.Cirrhotic myopathy (without impaired O2utilization) and cardiac chronotropic dysfunction do notadequately account for the observed decrease in aerobiccapacity.
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Epstein, S.K., Ciubotaru, R.L., Zilberberg, M.D. et al. Analysis of Impaired Exercise Capacity in Patients with Cirrhosis. Dig Dis Sci 43, 1701–1707 (1998). https://doi.org/10.1023/A:1018867232562
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DOI: https://doi.org/10.1023/A:1018867232562