Prognostic value of key variables from cardiopulmonary exercise testing in patients with COPD: 42-month follow-up

Goulart, Cássia da Luz; Oliveira, Murilo Rezende; Alburquerque‐Sendín, Francisco; Mendes, Renata Gonçalves; Arena, Ross; Borghi‐Silva, Audrey

doi:10.1016/j.rmed.2022.106856

Cited by 3 publications

(5 citation statements)

References 22 publications

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“…56 Elevated values of normalV˙ E /normalV˙O 2AT/nadir may suggest an increased dead space fraction and hyperventilation, a pattern analogous to that indicated by normalV˙ E /normalV˙CO 2AT/nadir . It is worth mentioning that although the normalV˙ E /normalV˙CO 2 slope has been used in patients with COPD, 6,8 normalV˙ E /normalV˙CO 2AT/nadir is generally favored over normalV˙ E /normalV˙CO 2 slope. 26,56 In the present study, we opted to use normalV˙ E /normalV˙O 2AT/nadir for simplicity and did not include …”

Section: Discussionmentioning

confidence: 99%

“…For example, one previous study initially only used a limited set of CPET variables, such as normalV˙ E , normalV˙O 2peak , and normalV˙ E /normalV˙CO 2 slope in their Cox regression analysis, and subsequently sex and age variables were introduced arbitrarily. 6 The authors of that study suggested that future investigations should include other CPET variables. Another study by Ewert et al in the same year also used multivariate Cox regression with stepwise selection and selected age, dyspnea, and normalV˙O 2peak /kg among other variables.…”

Section: Discussionmentioning

confidence: 99%

“…16 Importantly, these factors can contribute individually or in combination. 5,6,9,[12][13][14][15]18,19,[21][22][23]28,29 Among these factors, BMI, forced expiratory volume in one second (FEV 1 ) % predicted (FEV 1 %) and exercise intolerance, as measured by the six-minute walking distance (6MWD) and peak oxygen uptake ( _ VO 2peak ), are widely recognized. The 6MWD is typically reported in meters 5,24,28 or as a percentage of predicted values, while _ VO 2peak is expressed in mL/min 27 or mL/min/kg 30 or as a percentage of predicted values ( _ VO 2peak %).…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Several predictive factors for COPD mortality have been identified, including anthropometric measures, primary and secondary lung pathophysiology, symptoms, and clinically significant outcomes. 3–25 These factors include lower body mass index (BMI), 5 emphysema, 15 poor lung function, 3,4,10,11,15,20,26 reduced inspiratory and upper and lower limb muscle strength, 20,27,28 hypoxemia/hypercapnia, 11 exertional oxyhemoglobin desaturation, 24 elevated dyspnea score, 17 exercise intolerance, 4,6,8,15,24,27,28 poor health status, 7 acute exacerbation frequency, 22 and comorbidities. 16 Importantly, these factors can contribute individually or in combination.…”

Section: Introductionmentioning

confidence: 99%

“…16 Importantly, these factors can contribute individually or in combination. 5,6,9,12–15,18,19,21–23,28,29…”

Section: Introductionmentioning

confidence: 99%

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Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O_2peak or FEV₁% the gold standard?

Chuang,

Wang

2023

Chron Respir Dis

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Despite our knowledge of the risk factors for mortality associated with chronic obstructive pulmonary disease (COPD), the mortality rate for this condition continues to increase. This study aimed to investigate the predictive power of physiological variables on all-cause mortality in COPD patients compared to peak oxygen uptake ([Formula: see text]O2peak) and forced expired volume in one second (FEV1). We conducted a retrospective study of 182 COPD patients with complete lung function tests, cardiopulmonary exercise testing (CPET), and survival data. Cox regression analysis was used to estimate the hazard ratios for all-cause mortality. The median follow-up period was 6.8 (IQR 3.9-9.2) years. Out of the 182 patients in our study, sixty-two (34.1%) succumbed to various causes. Of these, 27.4% ( n = 17) experienced acute exacerbations, 24.2% ( n = 15) had advanced cancer, and 12.9% ( n = 8) had cardiovascular disease as the primary cause of death. Another 25.8% ( n = 16) passed away due to other underlying conditions, while 6.5% ( n = 4) had an unknown cause of death. One patient's demise was attributed to a benign tumor, and another's to a connective tissue disease. The ratio of tidal volume to total lung capacity (VTpeak/TLC) and the ratio of minute ventilation and [Formula: see text]O2 at nadir ([Formula: see text]E/[Formula: see text]O2nadir) (AUR 0.83, 95% CI 0.76-0.91) were superior predictors of all-cause mortality compared to [Formula: see text]O2peak and FEV1%. A mortality prediction formula was derived using these variables. This study highlights the potential of VTpeak/TLC and [Formula: see text]E/[Formula: see text]O2nadir as predictive markers for COPD all-cause mortality in COPD. CPET is an effective tool for evaluating COPD mortality; however, the predictive equation requires further validation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…16 Importantly, these factors can contribute individually or in combination. 5,6,9,12–15,18,19,21–23,28,29…”

Section: Introductionmentioning

confidence: 99%

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Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O_2peak or FEV₁% the gold standard?

Chuang,

Wang

2023

Chron Respir Dis

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Dynamic hyperinflation is a risk factor for mortality and severe exacerbations in COPD patients

Lorenzana,

Galera,

Casitas

et al. 2024

Respiratory Medicine

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The six-minute step test can predict COPD exacerbations: a 36-month follow-up study

Santos-de-Araújo,

da Luz Goulart,

Marinho

et al. 2024

Sci Rep

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The six-minute step test (6MST) has been shown to be effective in assessing exercise capacity in individuals with COPD regardless of severity and, despite its easy execution, accessibility and validity, information on the prognostic power of this test remains uncertain. The aim of this study is to investigate whether the 6MST can predict the occurrence of exacerbations in patients with COPD. This is a prospective cohort study with a 36-month follow-up in patients with COPD. All patients completed a clinical assessment, followed by pulmonary function testing and a 6MST. The 6MST was performed on a 20 cm high step; heart rate, blood pressure, oxygen saturation, BORG dyspnea and fatigue were collected. Sixty-four patients were included in the study, the majority being elderly men. Performance on the 6MST demonstrated lower performance compared to normative values proposed in the literature, indicating a reduced functional capacity. Kaplan Meier analysis revealed that ≤ 59 steps climbed during the 6MST was a strong predictor of COPD exacerbation over a 36-month follow-up. We have identified a minimal threshold number of steps (≤ 59) obtained through the 6MST may be able predict the risk of exacerbations in patients with COPD.

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Prognostic value of key variables from cardiopulmonary exercise testing in patients with COPD: 42-month follow-up

Cited by 3 publications

References 22 publications

Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O_2peak or FEV₁% the gold standard?

Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O_2peak or FEV₁% the gold standard?

Dynamic hyperinflation is a risk factor for mortality and severe exacerbations in COPD patients

The six-minute step test can predict COPD exacerbations: a 36-month follow-up study

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Prognostic value of key variables from cardiopulmonary exercise testing in patients with COPD: 42-month follow-up

Cited by 3 publications

References 22 publications

Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O2peak or FEV1% the gold standard?

Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O2peak or FEV1% the gold standard?

Dynamic hyperinflation is a risk factor for mortality and severe exacerbations in COPD patients

The six-minute step test can predict COPD exacerbations: a 36-month follow-up study

Contact Info

Product

Resources

About

Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O_2peak or FEV₁% the gold standard?

Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study – Is V̇O_2peak or FEV₁% the gold standard?