Open Access Highly Accessed Research article

MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

Effrosyni D Manali1, Panagiotis Lyberopoulos1, Christina Triantafillidou1, Likourgos F Kolilekas1, Christina Sotiropoulou2, Joseph Milic-Emili3, Charis Roussos2 and Spyros A Papiris1*

Author Affiliations

1 2nd Pulmonary Department, "Attikon" University Hospital, Athens Medical School, National and Kapodistrian University of Athens, Greece, 1 Rimini Street, 12462, Haidari, Greece

2 Applied Biomedical Research & Training Center "Marianthi Simou", Department of Critical Care & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Ploutarchou 3, Str 10675 Greece

3 Meakins-Cristie Laboratories, McGill University, 3626 St. Urbain Str, Montreal, Quebec H2X2P2, Canada

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BMC Pulmonary Medicine 2010, 10:32  doi:10.1186/1471-2466-10-32

Published: 28 May 2010

Abstract

Background

Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF). The Medical Research Chronic (MRC) chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET) and the 6-minute walk test (6MWT) are shown to provide information on the severity and survival of disease.

Methods

We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients

Results

Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p < 0.001), the SPO2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p < 0.001 respectively) and the desaturation index (r = .634, p = 0.001) for the 6MWT; the MRC score and VO2 peak/kg (r = -.731, p < 0.001), SPO2 at peak exercise (r = -. 682, p < 0.001), VE/VCO2 slope (r = .731, p < 0.001), VE/VCO2 at AT (r = .630, p = 0.002) and the Borg scale at peak exercise (r = .50, p = 0.01) for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT.

Conclusion

In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.