PMID- 30956797
OWN - NLM
STAT- MEDLINE
DCOM- 20200420
LR  - 20200420
IS  - 2052-4439 (Print)
IS  - 2052-4439 (Electronic)
IS  - 2052-4439 (Linking)
VI  - 6
IP  - 1
DP  - 2019
TI  - Veterans Specific Activity Questionnaire (VSAQ): a new and efficient method of 
      assessing exercise capacity in patients with pulmonary arteriovenous 
      malformations.
PG  - e000351
LID - 10.1136/bmjresp-2018-000351 [doi]
LID - e000351
AB  - INTRODUCTION: Assessment of performance status is an important component of 
      clinical management of patients with pulmonary arteriovenous malformations 
      (PAVMs). Usual methods are time-consuming and insensitive to variations within 
      normal or supranormal exercise capacity. METHODS: The Veterans Specific Activity 
      Questionnaire (VSAQ) was modified to facilitate completion by patients 
      independently. Patient-reported activity limitations were converted to the 
      Medical Research Council (MRC) Dyspnoea Scale, New York Heart Association (NYHA) 
      classification and metabolic equivalents (METs) in which 1 MET equals the 
      consumption of 3.5 mL O(2) per kilogram of body weight per minute. RESULTS: The 
      study population consisted of 71 patients with PAVMs aged 20-85 (median 52) 
      years. Oxygen saturation (SaO(2)) was 80%-99.5 % (median 96%), and haemoglobin 
      was 73-169 g/L in women and 123-197 g/L in men (p<0.0001). Arterial oxygen 
      content (CaO(2)) (1.34 x [haemoglobin x SaO(2)]/100) was maintained unless iron 
      deficiency was present. Most patients (49/71, 69%) did not need to stop until 
      activities more energetic than walking briskly at 4 mph were achieved (6.4 km per 
      hour, VSAQ >5, MRC Dyspnoea Scale 1 or 2, NYHA class I). SaO(2) was inversely 
      associated with the MRC Dyspnoea Scale and NYHA class, but not the VSAQ. Raw VSAQ 
      scores captured a marked difference between men and women. METs were also higher 
      in men at 3.97-15.55 (median 8.84) kcal/kg/min, compared with 1.33-14.4 (median 
      8.25) kcal/kg/min (p=0.0039). There was only a modest association between METs 
      and SaO(2) (p=0.044), but a stronger association between METs and haemoglobin (p 
      =0.001). In crude and sex-adjusted regression, the CaO(2) was more strongly 
      associated with METs than either SaO(2) or haemoglobin in isolation. CONCLUSION: 
      The VSAQ, capturing patient-reported outcome measures, is an efficient and 
      quantifiable measure of exercise capacity that can be readily employed in 
      clinical services particularly where patients have normal to high exercise 
      tolerance. In the PAVM population, exercise capacity reflects haemoglobin and 
      CaO(2) more than SaO(2), even where SaO(2) measurements are low.
FAU - Gawecki, Filip
AU  - Gawecki F
AD  - Imperial College School of Medicine, London, UK.
AD  - NHLI Respiratory Sciences, Imperial College London, London, UK.
FAU - Myers, Jonathan
AU  - Myers J
AD  - Department of Cardiology, VA Palo Alto Health Care System, Palo Alto, California, 
      USA.
FAU - Shovlin, Claire L
AU  - Shovlin CL
AUID- ORCID: 0000-0001-9007-5775
AD  - NHLI Vascular Sciences, Imperial College London, London, UK.
AD  - Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20190301
PL  - England
TA  - BMJ Open Respir Res
JT  - BMJ open respiratory research
JID - 101638061
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arteriovenous Malformations/*complications/diagnosis/physiopathology
MH  - Exercise Tolerance/*physiology
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Hypoxia/*diagnosis/etiology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/*abnormalities
MH  - Pulmonary Veins/*abnormalities
MH  - *Self Report
MH  - United Kingdom
MH  - Veterans
MH  - Young Adult
PMC - PMC6424292
OTO - NOTNLM
OT  - exercise
OT  - lung physiology
OT  - perception of asthma/breathlessness
OT  - rare lung diseases
COIS- Competing interests: None declared.
EDAT- 2019/04/09 06:00
MHDA- 2019/04/09 06:01
PMCR- 2019/03/01
CRDT- 2019/04/09 06:00
PHST- 2018/08/29 00:00 [received]
PHST- 2018/11/20 00:00 [accepted]
PHST- 2019/04/09 06:00 [entrez]
PHST- 2019/04/09 06:00 [pubmed]
PHST- 2019/04/09 06:01 [medline]
PHST- 2019/03/01 00:00 [pmc-release]
AID - bmjresp-2018-000351 [pii]
AID - 10.1136/bmjresp-2018-000351 [doi]
PST - epublish
SO  - BMJ Open Respir Res. 2019 Mar 1;6(1):e000351. doi: 10.1136/bmjresp-2018-000351. 
      eCollection 2019.