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Inspiratory capacity-to-total lung capacity ratio and dyspnoea predict exercise capacity decline in COPD
Ramon, Maria A. Ferrer, Jaume Gimeno-Santos, Elena Donaire-Gonzalez, David Rodríguez, Esther Balcells, Eva de Batlle, Jordi Benet, Marta Guerra, Stefano Sauleda, Jaume
Ramon, Maria A.
Ferrer, Jaume
Gimeno-Santos, Elena
Donaire-Gonzalez, David
Rodríguez, Esther
Balcells, Eva
de Batlle, Jordi
Benet, Marta
Guerra, Stefano
Sauleda, Jaume
Author
Ramon, Maria A.
Ferrer, Jaume
Gimeno-Santos, Elena
Donaire-Gonzalez, David
Rodríguez, Esther
Balcells, Eva
de Batlle, Jordi
Benet, Marta
Guerra, Stefano
Sauleda, Jaume
Ferrer, Antoni
Farrero, Eva
Gea, Joaquim
Barberà, Joan A.
Agustí, Àlvar
Rodriguez-Roisin, Robert
Antó, Josep M.
Garcia-Aymerich, Judith
Ferrer, Jaume
Gimeno-Santos, Elena
Donaire-Gonzalez, David
Rodríguez, Esther
Balcells, Eva
de Batlle, Jordi
Benet, Marta
Guerra, Stefano
Sauleda, Jaume
Ferrer, Antoni
Farrero, Eva
Gea, Joaquim
Barberà, Joan A.
Agustí, Àlvar
Rodriguez-Roisin, Robert
Antó, Josep M.
Garcia-Aymerich, Judith
Abstract
Background and objective: Exercise capacity decline is a predictor of mortality in patients with chronic obstructive pulmonary disease (COPD). Static pulmonary hyperinflation is a key determinant of exercise performance, but its effect on the longitudinal decline in exercise capacity remains unknown. We aimed to study the relationship between the inspiratory capacity‐to‐total lung capacity (IC/TLC) ratio and exercise capacity decline in COPD. Methods: We measured IC/TLC and other relevant clinical and functional variables in 342 clinically stable patients with COPD. The 6‐min walk distance (6MWD) was determined at recruitment and after a mean ± SD of 1.7 ± 0.3 years. The annual rate of change in 6MWD was calculated. Multiple imputation to account for losses during follow up was implemented, and multivariate regression was used to analyze predictive factors of 6MWD decline. Results: Mean decline rate in the 6MWD was 21.9 ± 34.1 m/year. In the bivariate analysis, patients with lower levels of IC/TLC had greater 6MWD decline (−27.4 ± 42.5, −24.9 ± 36.5 and −13.4 ± 39.9 m/year in the first, second and third tertile of IC/TLC, respectively; P‐for‐trend = 0.018). From other potential risk factors considered, dyspnoea, health status, serum C‐reactive protein and Borg dyspnoea score at the end of the exercise test were related to exercise capacity decline. In the multivariate regression model, only IC/TLC (β = 0.7 m/year per each percentage unit of IC/TLC; P = 0.007) and dyspnoea (mMRC ≥ 2) (β = −14.6 m/year; P = 0.013) were associated with the annual rate of 6MWD change. Conclusion: IC/TLC and dyspnoea in clinically stable patients with COPD predict their exercise capacity decline and may help to guide early therapeutic interventions.
Keywords
chronic obstructive pulmonary disease, cohort study, disease progression, exercise capacity, 6-min walk distance
Date
2016
Type
Journal article
Journal
Respirology
Book
Volume
21
Issue
3
Page Range
476-482
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled