The relationship between cardiac function, the BODE index and functional profile in patients with Chronic Obstructive Pulmonary Disease in the exacerbation phase

• Grant number: 17/22080-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): May 01, 2018
• Effective date (End): December 31, 2018
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Renata Gonçalves Mendes
• Grantee: Camila da Silva Rocha Tomaz
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Chronic obstructive pulmonary disease (COPD) ranks 5th among the leading causes of death in the world. This course has a decline in functional capacity, quality of life, as well as other organic functions such as cardiac function, and periods of exacerbation may result in even more significant loses to this population. In addition, the BODE index, that involves multidimensional evaluation of the COPD patient, has been widely used in these patients to better categorize the disease and predict clinical outcomes. However, there is still no information about the relationship between the cardiac function of these patients and the BODE index as well as the general health status and functional capacity in patients with COPD in the exacerbation phase. Objectives: This study aims to verify if there is an association between BODE index and functional capacity with cardiac function, and to verify possible association between the general health status, using the COPD Assessment Test (CAT) questionnaire, with the distance covered in the six-minute walk test (6MWD) in patients undergoing exacerbation and hospital admission. Methods: The sample will be composed of 13 patients of both genders, diagnosed with COPD and hospitalized for treatment of exacerbation. The BODE index will be calculated using the variables forced expiratory volume in the first second (FEV1) obtained by spirometry, distance walked in the six-minute walk test (6MWT), modified Medical Research Council (mMRC) scale for dyspnoea and body mass index (BMI). The 6MWT will be performed 72 hours after initiation of standard exacerbation therapy. Spirometry and echocardiography will be performed after the acute exacerbation period to confirm the diagnosis and severity of COPD and to verify the variables of systolic and diastolic cardiac function. The systolic function will be evaluated by the left ventricular ejection fraction (EF) and the diastolic function by the E/A ratio (representing the relation between fast filling phase (E) and atrial contraction (A)), E/e '(ventricular filling pressure), mean parietal diameter and volume (AE), and mitral tissue Doppler). For statistical analysis, the Pearson correlation test will be performed to verify association between variables, with a significance level of 5% (p <0.05). Hypotesis: It is hypothesized that there will be a significant and negative association between cardiac function (systolic and diastolic function of the left ventricle) and BODE index, as well as a significant and positive association with functional capacity assessed by the 6MWT and health status assessed by CAT. Expected results: We believe that the present study contributes to add knowledge to the health area to better guide the professional involved in the care of this population Knowing the relationship between cardiac variables and functional capacity, general health status, and BODE index, allows professionals to better reflect on the patient in question and the behaviors that may benefit different clinical outcomes and may also help future investigations that seek to minimize the occurrence and impact of COPD in this population. (AU)