Prognostic value of key variables from cardiopulmonary exercise testing in patients with COPD: 42-month follow-up - 11/05/22
Abstract |
Aim |
To identify better predictors of early death in patients with chronic obstructive pulmonary disease (COPD) using potential predictors derived from key measures obtained from cardiopulmonary exercise testing (CPET).
Methods |
This is a prospective, cohort study with 42-month follow-up in 126 COPD patients. Every patient completed the clinical evaluation, followed by a pulmonary function test and CPET. CPET was performed on a cycle ergometer with electromagnetic braking and ventilatory expired analysis was measured breath-by-breath using a computer-based system. Peak oxygen consumption (V̇O2, mlO2. kg−1. min−1), minute ventilation/carbon dioxide production and the, minute ventilation (V̇E, L/min), and the V̇E/carbon dioxide production (V̇E/V̇CO2) slope were obtained from CPET.
Results |
48 (38%) patients died during the 42-month follow-up. Kaplan Meier analysis revealed a V̇E/V̇CO2 slope ≥30, peak V̇E ≤ 25.7L/min and peak V̇O2 ≤ 13.8 mlO2. kg−1. min−1were strong predictors of mortality in COPD patients. Cox regression revealed that the V̇O2 peak ≤13.8 mlO2. kg−1. min−1 (CI 95% 0.08–0.93), V̇E/V̇CO2 slope ≥30 (CI 95% 0.07–0.94), V̇E peak ≤25.7 L/min (CI 95% 0.01–0.15), Sex (CI 95% 0.04–0.55) and Age (CI 95% 1.03–1.2) were the main predictors of mortality risk.
Conclusion |
Diminished exercise capacity and peak ventilation as well as ventilatory inefficiency are independent prognostic markers. Similar to patients with heart failure, CPET may be a valuable clinical assessment in the COPD population.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We identified that widely used markers of ventilatory inefficiency and exercise capacity were the only CPET variables to be independent predictors of mortality. |
• | There was a marked increase in the risk of mortality in patients with a V̇E/V̇CO2 slope ≥30, V̇E peak ≤25.7 L/min and V̇O2 peak ≤13.8 mlO2. kg−1. min−1. |
• | Moreover, therapeutic approaches, such as cardiopulmonary rehabilitation, may consider focusing on improving these metabolic and ventilatory markers as an indicator of clinical improvement and prognosis in patients with COPD. |
• | Depressed exercise ventilation and exercise capacity as well as ventilatory inefficiency are independent prognostic marker in COPD patients. |
Keywords : COPD, CPET, Oxygen uptake, Mortality
Plan
Vol 197
Article 106856- juin 2022 Retour au numéro
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