Correlation between ventricular function as assessed by echocardiography and six-minute walk test as a surrogate of functional capacity in patients with chronic obstructive pulmonary disease

IF 1 Q4 RESPIRATORY SYSTEM
M. Khalil, H. Salem, Hossam-Eldin Abdil-Hamid, M. Zakaria
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Abstract

Background Exercise intolerance is common in patients with chronic obstructive pulmonary disease (COPD), which has multiple mechanisms underlying its progression. Ventricular dysfunction may play a role in the development of exercise incapacity in patients with COPD. Aim To investigate the possible contribution of left ventricular (LV) and right ventricular (RV) dysfunction (either systolic or diastolic) in development of exercise intolerance in patients with COPD. Patients and methods A total of 60 patients with diagnosis of COPD were categorized according to GOLD spirometric stage into two groups (group 1: mild to moderate COPD, and group 2: severe to very severe COPD). Both groups were evaluated by spirometry, ECG, chest radiography, routine laboratory investigation, 6-min walk test, and echocardiography including tissue Doppler imaging. Results The average age in the whole study group was 56.63±10.33 years. Male patients in the study were 46 (76.7%) and female patients were 14 (23.3%). Mean maximum walk distance among the whole group was 342.75±54.85 m. There was a significant correlation between 6-min walk distance and transtricuspid E velocity, tricuspid E/A, and transtricuspid deceleration time (P=0.011, 0.015, and 0.021, respectively). There was no significant correlation between 6-min walk distance and parameters of LV diastolic dysfunction. Prevalence of ventricular dysfunction was as follow: LV systolic dysfunction 3.3%, LV diastolic dysfunction 30%, RV systolic dysfunction 21%, and RV diastolic dysfunction 46%. Conclusion RV diastolic dysfunction may be a contributing factor in the progression of exercise intolerance in COPD. Although LV diastolic dysfunction may not be associated with exercise intolerance, it is still prevalent in COPD and must be assessed and managed through the course of the disease and especially during exacerbation.
慢性阻塞性肺疾病患者超声心动图评估的心室功能与6分钟步行试验替代功能容量的相关性
运动不耐受在慢性阻塞性肺疾病(COPD)患者中很常见,其进展有多种机制。心室功能障碍可能在COPD患者运动能力丧失的发展中起作用。目的探讨左心室(LV)和右心室(RV)功能障碍(收缩期或舒张期)在COPD患者运动不耐受发展中的可能作用。患者与方法将60例诊断为COPD的患者根据GOLD肺量分期分为两组(1组:轻度至中度COPD, 2组:重度至极重度COPD)。两组均通过肺活量测定、心电图、胸片、常规实验室检查、6分钟步行试验和超声心动图(包括组织多普勒成像)进行评估。结果全组患者平均年龄56.63±10.33岁。男性46例(76.7%),女性14例(23.3%)。全组平均最大步行距离为342.75±54.85 m。6 min步行距离与三尖瓣E速度、三尖瓣E/ a、三尖瓣减速时间有显著相关(P分别为0.011、0.015、0.021)。6 min步行距离与左室舒张功能障碍参数无显著相关性。左室收缩功能不全发生率为3.3%,左室舒张功能不全发生率为30%,右室收缩功能不全发生率为21%,左室舒张功能不全发生率为46%。结论右心室舒张功能障碍可能是COPD运动耐受不良进展的一个因素。尽管左室舒张功能障碍可能与运动不耐受无关,但它在COPD中仍然普遍存在,必须在病程中进行评估和管理,尤其是在恶化期间。
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来源期刊
Egyptian Journal of Bronchology
Egyptian Journal of Bronchology RESPIRATORY SYSTEM-
自引率
7.70%
发文量
56
审稿时长
9 weeks
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