Evaluation of Cardiopulmonary Exercise Testing (CPET) as a Prognostic Tool in Idiopathic Pulmonary Fibrosis (IPF)

  • Richard J Davis

Student thesis: Master's ThesisMaster of Science (MSc)

Abstract

Personalised medicine is a medical approach that emphasises the customisation of healthcare, with all decisions and practices being tailored to individual patients.

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing condition of the lungs with a median survival of 2-3 years from diagnosis. There is however vast heterogeneity in terms of presenting features, severity and disease course. Individual survival varies greatly as a result, leading to difficulties for patients and clinicians in terms of end-of-life discussions, treatment choices and conduct of clinical trials.

Clinicians would benefit from tools that would help to better predict clinical progression or track response to therapy. Several prognostic tools have been used in IPF with variable success. Cardio-Pulmonary Exercise Testing (CPET) has been proposed as a potentially effective tool for the early detection of gas exchange abnormalities in lung diseases but its prognostic value remains uncertain. There are limited data available on the use of CPET as a predictive tool for disease progression in the setting of IPF, with a weak correlation between CPET and mortality reported in small cohorts. The predictive value of CPET in determining future disease progression and its relationship with Quality of Life (QoL) measurements and lung physiology is not known.

This thesis aimsto test the hypothesisthat CPET would be feasible in a population of mild to moderate IPF patients and more sensitive to change in patient’s health status than 6 Minute Walk Test (6MWT), Forced Vital Capacity (FVC) or Transfer factor for carbon monoxide (TLCO), the routine clinical tests used globally today.
Date of Award24 Jun 2021
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorNick A Maskell (Supervisor) & Ann Millar (Supervisor)

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