Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Kidney Transplant Recipients

Alessandro Patti, Daniel Neunhaeuserer, Andrea Gasperetti, Veronica Baioccato, Marco Vecchiato, Francesca Battista, Francesco Marchini, Marco Bergamin, Lucrezia Furian and Andrea Ermolao
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Alessandro Patti: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Daniel Neunhaeuserer: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Andrea Gasperetti: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Veronica Baioccato: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Marco Vecchiato: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Francesca Battista: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Francesco Marchini: Department of Medicine, Nephrology, University Hospital of Padua, 35128 Padova, Italy
Marco Bergamin: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy
Lucrezia Furian: Kidney and Pancreas Transplantation Unit, University Hospital of Padua, 35128 Padua, Italy
Andrea Ermolao: Sport and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy

IJERPH, 2021, vol. 18, issue 17, 1-13

Abstract: The overshoot of the respiratory exchange ratio (RER) during recovery from exercise has been found to be reduced in magnitude among patients with heart failure. The aim of this study is to investigate whether this phenomenon could also be present in patients with peripheral, and not cardiac, limitations to exercise such as kidney transplant recipients (KTRs). In this retrospective cross-sectional study, KTRs were evaluated with maximal cardiopulmonary exercise testing (CPET) assessing the RER overshoot parameters during recovery: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot (RER mag = (RER max-peak RER)/peak RER%) and the linear slope of the RER increase after the end of exercise. A total of 57 KTRs were included in the study (16 females), all of them showing a significant RER overshoot (RER mag: 28.4 ± 12.7%). Moreover, the RER mag showed significant correlations with the fitness of patients (peak VO 2 : ? = 0.57, p < 0.01) and cardiorespiratory efficiency (VE/VCO 2 slope: r = ?0.32, p < 0.05; oxygen uptake efficiency slope (OUES): r = 0.48, p < 0.01). Indeed, the RER mag was significantly different between the subgroups stratified by Weber’s fitness class or a ventilatory efficiency class. Our study is the first to investigate recovery of the RER in a population of KTRs, which correlates well with known prognostic CPET markers of cardiorespiratory fitness, determining the RER mag as the most meaningful RER overshoot parameter. Thus, the RER recovery might be included in CPET evaluations to further improve prognostic risk stratifications in KTRs and other chronic diseases.

Keywords: cardiopulmonary exercise test; renal transplantation; exercise; nephrology; functional evaluation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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