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JOURNAL Previously Revista Portuguesa de Pneumologia volume 25 / especial congresso 3 /Novembro 2019 35th CONGRESS OF PULMONOLOGY Praia da Falésia – Centro de Congressos Epic Sana, Algarve, 7th-9th November 2019 ISSN 2531-0429 www.journalpulmonology.org Portada_25_3.indd 1 29/10/19 14:56 JOURNAL Previously Revista Portuguesa de Pneumologia volume 25 / especial congresso 3 /Novembro 2019 35th CONGRESS OF PULMONOLOGY Praia da Falésia – Centro de Congressos Epic Sana, Algarve, 7th-9th November 2019 www.journalpulmonology.org ISSN 2531-0429 www.journalpulmonology.org Volume 25. Especial Congresso 3. Novembro 2019 35th CONGRESS OF PULMONOLOGY Praia da Falésia – Centro de Congressos Epic Sana, Algarve, 7th-9th November 2019 Contents Oral communications . 1 Commented posters . 45 Exposed posters . 122 00 Sumario 25-3.indd 1 29/10/19 14:58 Pulmonol. 2019;25(Esp Cong 3):1-44 JOURNAL Previously Revista Portuguesa de Pneumologia volume 25 / especial congresso 3 /Novembro 2019 35th CONGRESS OF PULMONOLOGY Praia da Falésia – Centro de Congressos Epic Sana, Algarve, 7th-9th November 2019 www.journalpulmonology.org ISSN 2531-0429 www.journalpulmonology.org ORAL COMMUNICATIONS 35th Congress of Pulmonology Praia da Falésia – Centro de Congressos Epic Sana Algarve, 7th‑9th November 2019 CO 001. NONSPECIFIC VENTILATORY PATTERN: Conclusions: Interpretation of PFT using fixed percentages may EVALUATION BY FIXED PERCENTAGES VERSUS LIMITS lead to an overvaluation of functional changes, particularly in fe- OF NORMALITY male gender and older ages. This work attests the importance of using LLN versus fixed percentage as recommended in international C. Rijo, M. Silva, T. Duarte, S. Sousa, P. Duarte guidelines. Centro Hospitalar de Setúbal, EPE-Hospital de São Bernardo. Keywords: Pulmonary function test. Nonspecific ventilatory Introduction: Non-specific ventilatory pattern (NVP) is defined as pattern. Fixed percentage. Limits of normality. a low forced vital capacity (FVC), a low maximum expiratory volume at first second (FEV1), normal FEV1/FVC ratio and a normal total lung capacity (TLC). The American Thoracic Society/European Re- CO 002. EXERCISE TEST RESULTS IN PATIENTS spiratory Society (ATS/ERS) guidelines recommends the interpreta- WITH ALVEOLAR‑CAPILLARY DIFFUSION IMPAIRMENT: tion of pulmonary function tests (PFT) based on normal limits of A COMPARATIVE ANALYSIS normality (5th percentile), not taking into consideration the use of fixed percentages of the predicted value. T. Oliveira, P. Pinto, V. Almeida, R. Carvalho, M.J. Fernandes, Objectives: Evaluate PVI tests defined by fixed percentage and J. Gomes reinterpret them using the lower limits of normality (LLN), accord- Centro Hospitalar Universitário do Porto-Hospital de Santo ing to the European Coal and Steel Community (ECSC) reference António. equations. Methods: Retrospective study of the analysis of pulmonary function Introduction: Exercise capacity impairment in chronic respiratory tests (body plethysmography) performed since 2017 according to patients is multifactorial and stems from the pathophysiological ATS/ERS quality criteria. All PFT characterized by a NVP defined by specificities of each disease. In COPD, among other factors, the role fixed percentages were included. The tests were reanalyzed using of dynamic hyperinflation is recognized. In diffuse lung diseases, re- the limits of normality. All data were analyzed using software IBM® duction of lung compliance and lung microvasculopathy are relevant. SPPS® Statistics version 22. Additionally, alveolar-capillary diffusion impairment is present in Results: 111 plethysmographys with NVP by fixed percentage (54.9% both COPD patients – namely in the context of pulmonary emphysema males and 92.8% Caucasian) were included, with an average of – and patients with diffuse (mainly fibrotic) lung diseases. The 1-min- 62.16 years. The same tests were reanalyzed by the LLN method: ute sit-to-stand (1-STS) and 6-minute walk test (6MWT) evaluate the 58.6% of the NVP became normal (NP), 35.1% continued as NVP and exercise capacity of chronic respiratory patients. 6.3% became restrictive ventilatory pattern (RVP). A statistically Objectives: Compare patients with COPD and diffuse lung diseases significant difference was found in distribution between gender – with alveolar-capillary diffusion impairment – in their results in (p = 0.018), for men and women groups, we obtained 49.2% and 70% 1-STS and 6MWT tests. Understand the performance of these two of NP, respectively. The patterns defined by the LLN showed statis- tests in the measurement of exercise capacity impairment of these tically significant differences in age and the group of NP showed patients. older ages (p = 0.002 in men and p < 0.001 in women). A statisti- Methods: Prospective study taking place at the Pulmonology De- cally significant difference was noticed when comparing groups partment of a University Hospital Center including patients with below and over 75 years (p = 0.014). In the group older than 75 prescription of 6MWT, without exclusion criteria for 1-STS. Patients years, we observed 16 PN (88.9%), in comparison to the group with first perform the 6MWT or 1-STS and, after rest, the other test. In 75 years or less (52.7% PN). this analysis, only patients with DLCO < 80% predicted are included 2531-0437/© 2019 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 01 Comunicaciones 25-3.indd 1 29/10/19 14:58 2 35th Congress of Pulmonology and two groups of patients are compared: COPD and/or pulmonary RV (r = 0.273, p = 0.005) and DLCO (r = -0.409, p = 0.001). In a emphysema (COPD-E) [N = 54] and diffuse lung diseases(DLD) multivariate analyses to assess the influence of PFT on distance and [N = 24]. The SPSS® program for statistical analysis has been used. dessaturation of 6MWD, a 6MWD < 350m was positively associated Results: In COPD-E and DLD patients, respectively, the prevalence with final Borg index (r² = 0.140, p = 0.01). of men is 66.7 and 62.5%(p = 0.799), the mean age is 64.6 and 61 Conclusions: Despite observed correlations between PFT parame- years(p = 0.448), the mean BMI is 25.8 and 27.7 kg/m2 (p = 0.074), ters and 6MWT (distance, dSO2), none of the studied PFT para- the proportion of patients with mMRC dyspnea ≥ 2 is 56.6% and meters were able to predict the final 6MWT outcome, pointing out 29.2% (p = 0.03), the proportion of patients under home oxygen that other determinants may be involved. therapy is 11.1% and 4.2% (p = 0.427) and the mean DLCO is 52.6% Keywords: COPD. 6MWT. Lung function. and 54.8% (p = 0.559). In COPD-E patients, pre-BD FEV1 (median) = 44.6%; in DLD patients, pre-BD TLC(mean) = 89.7%. In DLD patients, the main diagnoses are: hypersensitivity pneumonitis(n = 5), idio- pathic pulmonary fibrosis(n = 4), non-specific interstitial pneumonia CO 004. AMYOTROPHIC LATERAL SCLEROSIS: IMPORTANT (n = 4) and sarcoidosis(n = 4). In 1-STS, no significant differences SURVIVAL FACTORS between both groups were found in the blood pressure, heart rate B. Mendes, A. Mineiro, C. Figueiredo, M. Cabral, A. Magalhães, and SpO2 responses, or end-test Borg (dyspnea/fatigue) scores. N. Caires, J. Rosa, M. Dias, J. Cardoso COPD-E patients performed significantly less repetitions than DLD patients (24.4 ± 6.1 and 30.2 ± 10.2, respectively; p = 0.015). In the Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa 6MWT, no significant differences between both groups were found Central. in the blood pressure, heart rate and SpO2 responses; However, Introduction: Amyotrophic lateral sclerosis (ALS) is a rare progres- end-test Borg(dyspnea) score is significantly higher in COPD-E pa- sive neurodegenerative disease of the motor neuron, that ultimate- tients than in DLD patients (5 ± 5 and 2.5 ± 5, respectively; p = 0.023) ly leads to respiratory failure and death. The median survival of but no significant differences in end-test Borg (fatigue) scores were these patients is 2 to 5 years since the beginning of the disease. found. 6MW Distance is lower in COPD-E patients (395.5 ± 143m) Factors as age, female gender and bulbar symptoms onset seem to than in DLD patients (413.1 ± 128.3m), but this difference is not be related to poor prognosis. statistically significant (p = 0.914). Objectives: Functional and clinical characterization of the patients Conclusions: Although both groups presented similar degrees of with ALS and analyse their survival. alveolar-capillary diffusion impairment, COPD-E patients had worse Methods: We conducted a retrospective study with evaluation of overall performance and became more symptomatic than DLD pa- all patients with ALS that were referred to our centre’s pulmon- tients in these exercise tests. Furthermore, in these patients with ology consultation during a ten-year period. Clinical and respira- alveolar-capillary diffusion impairment, the number of repetitions tory functional test data were recorded. We used the software performed on 1-STS seems to better express the greater limitation IBM SPSS Statistics 25 for data analyses. Kaplan-Meier curves of exercise capacity in COPD-E patients than the 6MWDistance. were used to analyse overall survival and Mantel-Cox test to com- Thus, the 1-STS test may be more indicative of the contribution of pare survival between groups. To compare the mean between specific COPD-E factors in exercise capacity impairment, namely FVC we used the parametric independent t-test. The results are dynamic hyperinflation. presented in mean (± standard deviation) or median [25 percen- Keywords: 6-minute walk test. 1-minute sit-to-stand. COPD. tile-75 percentile]. Diffuse lung disease. Alveolar-capillary diffusion impairment. Results: Forty-three patients were included in the study, 21 of them female gender (48.9%). The mean age of diagnosis in women (67.5 (± 2.1) years) was more advanced than in men (62.6 (± 2)).
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