TY - JOUR
T1 - Right ventricular systolic dysfunction is related to exercise intolerance in patients with chronic obstructive pulmonary disease
AU - Caminiti, Giuseppe
AU - Cardaci, Vittorio
AU - Conti, Vittoria
AU - D'antoni, Valentino
AU - Murugesan, Jeganath
AU - Battaglia, Daniela
AU - Volterrani, Maurizio
PY - 2015/1/3
Y1 - 2015/1/3
N2 - PURPOSE:: To evaluate the impact of right ventricular dysfunction on exercise tolerance and potential changes resulting from exercise training in patients with chronic obstructive pulmonary disease (COPD) undergoing pulmonary rehabilitation. METHODS:: Subjects were 44 patients with a history of symptomatic (Global Initiative for Chronic Obstructive Lung Disease classes 2-4) COPD attending a 4-week aerobic exercise training program. Right ventricle dysfunction was evaluated by echocardiography at admission using tricuspid annular plane systolic excursion (TAPSE). Exercise tolerance was evaluated at admission and discharge using the 6-minute walk test (6MWT). Change in distance walked (Δ6MWT) was defined as the difference between 6MWT distance at discharge minus distance at admission. Patients were divided into 2 groups according to the presence of right ventricle dysfunction (TAPSE ≤16 mm). RESULTS:: Median age and left ventricular ejection fraction was 70.2 ± 5.2 years and 54.4 ± 9.1%, respectively. Of the 44 patients, 14 (31.8%) had TAPSE ≤16 mm. Baseline 6MWT distance was less in the group with TAPSE ≤16 mm compared with TAPSE >16 mm (110.2 ± 34 vs 185.7 ± 41, respectively; P = .02). After the training program, 6MWT distance increased in both groups, but there was less increase in the group with TAPSE ≤16 mm compared with TAPSE >16 mm (+24.3% vs +32.8%, respectively; P <.001). Tricuspid annular plane systolic excursion was significantly correlated to distance walked at the baseline 6MWT (r = 0.44; P = .002) and to Δ6MWT (r = .36; P = .006). CONCLUSIONS:: Tricuspid annular plane systolic excursion ≤16 mm was an indicator of decreased 6MWT distance at baseline and 6MWT distance change in COPD patients undergoing pulmonary rehabilitation. This relationship seems to be independent of pulmonary function.
AB - PURPOSE:: To evaluate the impact of right ventricular dysfunction on exercise tolerance and potential changes resulting from exercise training in patients with chronic obstructive pulmonary disease (COPD) undergoing pulmonary rehabilitation. METHODS:: Subjects were 44 patients with a history of symptomatic (Global Initiative for Chronic Obstructive Lung Disease classes 2-4) COPD attending a 4-week aerobic exercise training program. Right ventricle dysfunction was evaluated by echocardiography at admission using tricuspid annular plane systolic excursion (TAPSE). Exercise tolerance was evaluated at admission and discharge using the 6-minute walk test (6MWT). Change in distance walked (Δ6MWT) was defined as the difference between 6MWT distance at discharge minus distance at admission. Patients were divided into 2 groups according to the presence of right ventricle dysfunction (TAPSE ≤16 mm). RESULTS:: Median age and left ventricular ejection fraction was 70.2 ± 5.2 years and 54.4 ± 9.1%, respectively. Of the 44 patients, 14 (31.8%) had TAPSE ≤16 mm. Baseline 6MWT distance was less in the group with TAPSE ≤16 mm compared with TAPSE >16 mm (110.2 ± 34 vs 185.7 ± 41, respectively; P = .02). After the training program, 6MWT distance increased in both groups, but there was less increase in the group with TAPSE ≤16 mm compared with TAPSE >16 mm (+24.3% vs +32.8%, respectively; P <.001). Tricuspid annular plane systolic excursion was significantly correlated to distance walked at the baseline 6MWT (r = 0.44; P = .002) and to Δ6MWT (r = .36; P = .006). CONCLUSIONS:: Tricuspid annular plane systolic excursion ≤16 mm was an indicator of decreased 6MWT distance at baseline and 6MWT distance change in COPD patients undergoing pulmonary rehabilitation. This relationship seems to be independent of pulmonary function.
KW - chronic obstructive pulmonary disease
KW - exercise tolerance
KW - right ventricular function
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U2 - 10.1097/HCR.0000000000000086
DO - 10.1097/HCR.0000000000000086
M3 - Article
C2 - 25360805
AN - SCOPUS:84920283909
VL - 35
SP - 70
EP - 74
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
SN - 1932-7501
IS - 1
ER -