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

Author(s)

Goulart, Cassia da Luz ; Oliveira, Murilo Rezende ; Alburquerque Sendin, Francisco ; Mendes, Renata Goncalves ; Arena, Ross ; Borghi-Silva, Audrey

• Document type: Journal article
• Source: RESPIRATORY MEDICINE; v. 197, p. 6-pg., 2022-04-20.

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 (VO2, mlO(2). kg(-1) min(-1)), minute ventilation/carbon dioxide production and the, minute ventilation (V-E, L/min), and the V-E/carbon dioxide production (V-E/VCO2) slope were obtained from CPET. Results: 48 (38%) patients died during the 42-month follow-up. Kaplan Meier analysis revealed a V-E/VCO2 slope >= 30, peak V-E <= 25.7L/min and peak VO2 <= 13.8 mlO(2). kg-(1) min(-1) were strong predictors of mortality in COPD patients. Cox regression revealed that the VO2 peak <= 13.8 mlO(2). kg(-1) min(-1) (CI 95% 0.08-0.93), V-E/VCO2 slope >= 30 (CI 95% 0.07-0.94), V-E 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. (AU)

• FAPESP's process: 18/03233-0 - Study of cardiorespiratory interaction and the supply of peripheral and cerebral oxygen as modulators of exercise capacity during bilevel application in the coexistence of COPD-CHF
• Grantee: Cássia da Luz Goulart
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 20/13465-5 - Identification of prognostic variables from the cardiopulmonary exercise test to stratify Heart Failure severity
• Grantee: Cássia da Luz Goulart
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate (Direct)