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      Exercise Capacity and Pulmonary Capacitance Are Attenuated in Patients with Nonalcoholic Steatohepatitis = Exercise Capacity and Pulmonary Capacitance Are Attenuated in Patients with Nonalcoholic Steatohepatitis

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      Purpose: The study was to investigate exercise capacity (peak oxygen uptake [peak VO<sub>2</sub>]) and pulmonary capacitance (GX<sub>cap</sub>), which is an estimate of pulmonary vascular capacitance, in patients with nonalcoho...

      Purpose: The study was to investigate exercise capacity (peak oxygen uptake [peak VO<sub>2</sub>]) and pulmonary capacitance (GX<sub>cap</sub>), which is an estimate of pulmonary vascular capacitance, in patients with nonalcoholic steatohepatitis (NASH).
      Methods: This study utilized a database of patients with NASH (n=26 [17 male and 9 female], aged 58.9±4.3 years) and healthy individuals (n=23 [12 male and 11 female, aged 58.6±7.9 years) who underwent a maximal exercise test on a recumbent cycle ergometer (Corival; Lode) in our laboratory. During cardiopulmonary exercise tests, breathing patterns and respiratory gas exchange including breathing efficiency (VE/VCO<sub>2</sub>) and end-tidal CO<sub>2</sub> (PETCO<sub>2</sub>) were measured. In addition, peak VO<sub>2</sub> was obtained via averaging the last 30 seconds at peak level and GX<sub>cap</sub> was obtained by calculation as follows: GX<sub>cap</sub>=oxygen pulse (O<sub>2</sub> pulse)×PETCO<sub>2</sub>.
      Results: The NASH group demonstrated reduced peak VO<sub>2</sub> relative to the healthy group (17.5±8.4 mL/kg/min vs. 34±10.2 mL/kg/min, respectively; p< 0.05). In addition, there was a higher VE/VCO<sub>2</sub> relationship in the NASH group relative to the healthy group (34.9±5.5 vs. 32.2±4.0, respectively; p< 0.05) and lower PETCO<sub>2</sub> in the NASH group compared to the healthy group (32.8±4.0 mm Hg vs. 35.3±3.8 mm Hg, respectively; p< 0.05). Furthermore, the NASH group showed lower GX<sub>cap</sub> than the healthy group (456±150 vs. 551±202, respectively; p< 0.05).
      Conclusion: Patients with NASH had reduced exercise capacity and pulmonary vascular capacitance relative to age-matched healthy adults and this may contribute to pulmonary pathophysiology in NASH.

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