Distance and Oxygen Desaturation During the 6-min Walk Test as Predictors of Long-term Mortality in Patients With COPD

Casanova, Ciro; Côté, Claudia; Marı́n, José Marı́a; Pinto-Plata, Víctor; de-Torres, Juan P.; Aguirre‐Jaime, Armando; Vassaux, Carlos; Celli, Bartolomé R.

doi:10.1378/chest.08-0520

Cited by 284 publications

(232 citation statements)

References 24 publications

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“…Recognition of these factors provides a more comprehensive assessment of COPD severity. Decreased exercise capacity measured as decreased peak oxygen uptake and decreased 6MWD predict mortality better than FEV1 [61,62]. Pulmonary rehabilitation with exercise training has been shown to increase exercise capacity and thus, it is possible to modify the functional capacity of patients [63,64].…”

Section: Copd and Impaired Functional Capacitymentioning

confidence: 99%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

Eur Respir J

1,480

1,113

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Increasing evidence indicates that chronic obstructive pulmonary disease (COPD) is a complex disease involving more than airflow obstruction. Airflow obstruction has profound effects on cardiac function and gas exchange with systemic consequences. In addition, as COPD results from inflammation and/or alterations in repair mechanisms, the ''spill-over'' of inflammatory mediators into the circulation may result in important systemic manifestations of the disease, such as skeletal muscle wasting and cachexia. Systemic inflammation may also initiate or worsen comorbid diseases, such as ischaemic heart disease, heart failure, osteoporosis, normocytic anaemia, lung cancer, depression and diabetes. Comorbid diseases potentiate the morbidity of COPD, leading to increased hospitalisations, mortality and healthcare costs. Comorbidities complicate the management of COPD and need to be evaluated carefully. Current therapies for comorbid diseases, such as statins and peroxisome proliferator-activated receptor-agonists, may provide unexpected benefits for COPD patients. Treatment of COPD inflammation may concomitantly treat systemic inflammation and associated comorbidities. However, new broad-spectrum anti-inflammatory treatments, such as phosphodiesterase 4 inhibitors, have significant side-effects so it may be necessary to develop inhaled drugs in the future. Another approach is the reversal of corticosteroid resistance, for example with effective antioxidants. More research is needed on COPD comorbidities and their treatment.

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Section: Copd and Impaired Functional Capacitymentioning

confidence: 99%

Systemic manifestations and comorbidities of COPD

Barnes¹,

Celli²

2009

Eur Respir J

1,480

1,113

View full text Add to dashboard Cite

show abstract

“…In general, patients with EID are characterized by severe airflow limitation, low diffusing carbon monoxide capacity (DLCO), reduced resting arterial oxygenation [6][7][8][9] and the presence of emphysema [10][11][12] In addition, EID is also related to numerous variables that include the rate of lung function decline and health status 13 , physical activity 14 , and the outcomes of hospitalization as well as mortality. 15,16 The determinants of EID, however, have not been validated in a large cohort of COPD patients followed up prospectively. The design and…”

Section: Introductionmentioning

confidence: 99%

Determinants of exercise-induced oxygen desaturation including pulmonary emphysema in COPD: Results from the ECLIPSE study

Andrianopoulos

Celli

Franssen

et al. 2016

Respiratory Medicine

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“…It has also been reported that 6-min walk distance and oxygen desaturation (measured as S pO 2 ) during the 6-min walk test are good predictors of long-term mortality in patients with COPD. 26 However, in a previous study we found that the P aO 2 slope was a significant independent prognostic factor for COPD, and was more closely associated with survival Fig. 2.…”

Section: Gas-exchange Abnormalitymentioning

confidence: 72%

Differences in Physiological Response to Exercise in Patients With Different COPD Severity

et al. 2013

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BACKGROUND: Patients with COPD have reduced exercise tolerance associated with dyspnea. This exercise intolerance is primarily due to impaired ventilatory mechanics, but it is also associated with a combination of factors, including inefficient gas exchange, lactic acidosis at a low work rate, and exercise-induced hypoxemia. The survival prognosis of COPD patients with severely reduced exercise capacity is extremely poor, but the pathophysiology of these patients during exercise remains to be accurately established. The present study aimed to characterize life-threatening factors such as hypoxemia, acidosis, and sympathetic activation during exercise in these patients. METHODS: We monitored changes in life-threatening factors and compared these factors among quartile groups, defined according to their peak oxygen uptake status. Ninety-one COPD subjects (82 males, 9 females, average age 69.7 ؎ 6.8 y) consecutively underwent incremental cardiopulmonary exercise testing using a cycle ergometer. Arterial blood gases, lactate, and catecholamines were measured during cardiopulmonary exercise testing. RESULTS: The pathophysiology of the COPD differed among the 4 subject groups. Subjects with the most severely reduced exercise capacity (peak oxygen uptake < 623 mL/min) were characterized by exercise-induced steep decrease in P aO 2 slope (؊78 ؎ 70 mm Hg/L/min), rapid progression of respiratory acidosis, little change in lactic acidosis, and sympathetic activation at low-intensity work load (plasma norepinephrine 1.41 ؎ 0.94 ng/mL at 20 watts work load), in addition to the limitation of increase in ventilation and impaired gas exchange. CONCLUSIONS: The mechanisms of exercise intolerance in COPD patients significantly differed among subjects with different exercise capacities. Subjects with the most severely reduced exercise capacity had the characteristics of exercise-induced hypoxemia, sympathetic overactivity, and progressive respiratory acidosis at low-intensity exercise. These lifethreatening pathophysiological conditions could be improved by medication and/or pulmonary rehabilitation.

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Distance and Oxygen Desaturation During the 6-min Walk Test as Predictors of Long-term Mortality in Patients With COPD

Cited by 284 publications

References 24 publications

Systemic manifestations and comorbidities of COPD

Systemic manifestations and comorbidities of COPD

Determinants of exercise-induced oxygen desaturation including pulmonary emphysema in COPD: Results from the ECLIPSE study

Differences in Physiological Response to Exercise in Patients With Different COPD Severity

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