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Prognostic predictors for survival in patients with COPD using cardiopulmonary exercise testing
Author(s) -
Hiraga Toru,
Maekura Ryoji,
Okuda Yoshinari,
Okamoto Takashi,
Hirotani Atsushi,
Kitada Seigo,
Yoshimura Kenji,
Yokota Soichiro,
Ito Masami,
Ogura Takeshi
Publication year - 2003
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1046/j.1475-0961.2003.00514.x
Subject(s) - medicine , copd , oxygen pulse , respiratory minute volume , cardiology , univariate analysis , vo2 max , multivariate analysis , hypoxemia , incremental exercise , ventilation (architecture) , tidal volume , body mass index , physical therapy , heart rate , respiratory system , blood pressure , mechanical engineering , engineering
Summary We studied the relationship between physiologic parameters in cardiopulmonary exercise testing (CPET) and prognosis in terms of survival time in patients with chronic obstructive pulmonary disease (COPD) in order to accurately assess the severity of the disease. From a group of 195 patients with COPD who had consecutively undergone CPET between July 1989 and October 1997, we enrolled 120 subjects (mean age 67·6 years, 104 males) with exertional dyspnoea into a cohort protocol. Of these subjects, 34 (28·3%) died during the 3–5‐year follow‐up period after CPET. By univariate analysis, the following factors were significantly associated with survival time: age, body mass index, %FVC, %FEV 1 , FEV 1 %, P a co 2 at rest, severity of exercise‐induced hypoxemia evaluated by Δ P a o 2 /Δ V̇ o 2 ( P a o 2 ‐slope), oxygen uptake, ventilation, tidal volume, P a co 2 and oxygen pulse at maximum exercise, as well as prescribing long‐term oxygen therapy. By multivariate analysis, age and the P a o 2 ‐slope showed significance as independent prognostic factors, and the P a o 2 ‐slope was most closely associated with the survival time. These results reveal that CPET is a useful technique to accurately assess the relationship between the functional impairments and the prognosis of patients with COPD.