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Knowing that diastolic dysfunction is frequent in this population, we hypothesize that a lack of cardiac adaptation through exercise might lead to premature increase in blood lactate concentrations in SCA patients, a potential trigger for acute disease complication. SCA patients were prospectively included in PHYSIO-EXDRE study and underwent a comprehensive stress test with a standardized incremental exercise protocol up to 4\u00a0mmol\u00a0L<jats:sup>\u22121<\/jats:sup>blood lactate concentration (BL4). Gas exchange, capillary lactate concentration and echocardiography were performed at baseline, during stress test (at \u223c\u00a02\u00a0mmol\u00a0L<jats:sup>\u22121<\/jats:sup>) and BL4. The population was divided into two groups and compared according to the median value of percentage of theoretical peak oxygen uptake (%<jats:inline-formula><jats:alternatives><jats:tex-math>$${\\dot{\\text{V}}\\text{O}}_{2peakth}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msub><mml:mrow><mml:mover><mml:mtext>V<\/mml:mtext><mml:mo>\u02d9<\/mml:mo><\/mml:mover><mml:mtext>O<\/mml:mtext><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><mml:mi>p<\/mml:mi><mml:mi>e<\/mml:mi><mml:mi>a<\/mml:mi><mml:mi>k<\/mml:mi><mml:mi>t<\/mml:mi><mml:mi>h<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math><\/jats:alternatives><\/jats:inline-formula>) at BL4. Twenty-nine patients were included (42\u2009\u00b1\u200912\u00a0years old, 48% of women). Most patients reached BL4 at low-intensity exercise [median value of predicted power output (W) was 37%], which corresponds to daily life activities. The median value of %<jats:inline-formula><jats:alternatives><jats:tex-math>$${\\dot{\\text{V}}\\text{O}}_{2peakth}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msub><mml:mrow><mml:mover><mml:mtext>V<\/mml:mtext><mml:mo>\u02d9<\/mml:mo><\/mml:mover><mml:mtext>O<\/mml:mtext><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><mml:mi>p<\/mml:mi><mml:mi>e<\/mml:mi><mml:mi>a<\/mml:mi><mml:mi>k<\/mml:mi><mml:mi>t<\/mml:mi><mml:mi>h<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math><\/jats:alternatives><\/jats:inline-formula>at BL4 was 39%. Interestingly, diastolic maladaptation using echocardiography during stress test along with hemoglobin concentration were independently associated to early occurrence of BL4. As BL4 occurs for low-intensity exercises, SCA patients may be subject to acidosis-related complications even during their daily life activities. Beyond assessing physical capacities, our study underlines that diastolic maladaptation during exercise is associated with an early increase in blood lactate concentration.<\/jats:p>","DOI":"10.1038\/s41598-024-61689-w","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T06:01:47Z","timestamp":1715752907000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiac diastolic maladaptation is associated with the severity of exercise intolerance in sickle cell anemia patients"],"prefix":"10.1038","volume":"14","author":[{"given":"Thomas","family":"d\u2019Humi\u00e8res","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Bouvarel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Boyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Savale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Guillet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Alassaad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"de Luna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enora","family":"Berti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihem","family":"Iles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Laure","family":"Pham Hung d\u2019Alexandry d\u2019Orengiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Audureau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Joelle","family":"Troupe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reine-Claude","family":"Schlatter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u00efs","family":"Lamadieu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Galact\u00e9ros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevi\u00e8ve","family":"Derumeaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent A.","family":"Messonnier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Bartolucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"61689_CR1","doi-asserted-by":"crossref","unstructured":"GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. 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