Predictors of cardiopulmonary exercise testing in COPD patients according to Weber classification

Author(s)

Caruso, Flavia Rossi ; Goulart, Cassia da Luz ; Bonjorno Jr, Jose Carlos ; de Oliveira, Claudio Ricardo ; Mendes, Renata Goncalves ; Arena, Ross ; Borghi-Silva, Audrey

• Document type: Journal article
• Source: HEART & LUNG; v. 62, p. 6-pg., 2023-06-24.

Abstract

Background: Weber classification stratifies cardiac patients based on peak oxygen consumption ((V) over dotO(2)), the gold-standard measure of exercise capacity. Objective: To determine if Weber classification is a useful tool to discriminate clinical phenotypes in COPD patients and to evaluate if disease severity and other clinical measures can predict (V) over dotO(2peak). Methods: Three hundred and six COPD patients underwent cardiopulmonary exercise testing (CPX) and were divided according to Weber class: 1) Weber A (n = 34); 2) Weber B (n = 88); 3) Weber C (n = 138); and 4) Weber D (n = 46). Results: Weber class D patients demonstrated a reduced (V) over dotO(2 peak), heart rate (HR), minute ventilation (V?E), oxygen (O2) pulse, circulatory power (CP), oxygen uptake efficiency slope (OUES), oxygen saturation (SpO2%), delta (D)HR and DSpO(2) when compared to Weber A and B (p<0.05). Moreover, Dyspnea and the (V) over dotE/carbon dioxide production ((V) over dotO(2)) slope were higher in Weber D compared with Weber C and A (p<0.001). Hierarchical regression analysis demonstrated significant predictors of (V) over dotO(2peak) (R2= 0.131; Adj R 2 = 1.25), including HR (b=0.5757; t = 5.7; P<0.001) and forced expiratory volume in one second (FEV1) (b=0.119; t = 2.16; P<0.03). Among the Weber C + D groups, predictors of (V) over dotO(2) (R = 0.78; R-2= 0.60; Adj R-2 =0.59), dyspnea (b=0.076; t =1.111; P<0.27) and maximal voluntary ventilation (MVV) (b=0.75; t = 1.14; P<0.00). Conclusion: Weber classification may be a useful tool to stratify cardiorespiratory fitness in COPD patients. Other clinical measures may be useful in predicting peak (V) over dotO(2) in mild-to-severe COPD, moreover different phenotypes may be important tool to improve physical capacity of chronic disease patients. (C) 2023 Published by Elsevier Inc. (AU)

• FAPESP's process: 18/18133-0 - Evaluation of mechanical ventilatory, cardiocirculatory and metabolic responses in dynamic exercise incremental symptom limited trial - FRIENDS Study
• Grantee: Flávia Cristina Rossi Caruso Bonjorno
• Support Opportunities: Scholarships in Brazil - Post-Doctoral