Published online before print
June 11, 2008 Eur Respir J 2008, doi:10.1183/09031936.00151707
Effects of Hyperinflation on the Oxygen Pulse as a Marker of Cardiac Performance in COPD
C. Vassaux 1,
L. Torre-Bouscoulet 2,
S. Zeineldine 1,
F. Cortopassi 1,
H. Paz-Díaz 1,
B.R. Celli 1,
V.M. Pinto-Plata 1*
1 Division of Pulmonary, Critical Care and Sleep Medicine. Caritas St Elizabeth's Medical Center. Tufts University School of Medicine, Boston, MA.
2 Division of Pulmonary, Critical Care and Sleep Medicine. Caritas St Elizabeth's Medical Center. Tufts University School of Medicine, Boston, MA.; and Departamento de Fisiología. Instituto Nacional de Enfermedades Respiratorias, México, D.F.
* To whom correspondence should be addressed. E-mail: vpinto{at}copdnet.org.
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Abstract |
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A decreased inspiratory to total lung capacity ratio (IC/TLC) is associated with dynamic hyperinflation (DH) and decreased exercise capacity. We hypothesized that static (low IC/TLC) and dynamic hyperinflation impair cardiac function assessed by O2 pulse at rest and during cardiopulmonary exercise test (CPET). We measured lung function, body mass index, handgrip strength and CPET parameters [oxygen uptake (ml·kg-1·min-1), O2 pulse (ml·beat-1)] in 87 COPD patients (ATS/ERS/GOLD 3–4) and 46 controls. The patients were divided into those with IC/TLC >25% or 25%. The IC/TLC at rest and at peak exercise was associated with O2 pulse (r=0.65, p<0.001 and r=0.68, p<0.001). Patients with IC/TLC 25% (n=45) had significantly lower exercise capacity, peak O2 pulse, O2 pulse, peak IC, peak IC/TLC, and IC/TLC%compared to patients with IC/TLC >25% and controls. During CPET, the O2 pulse was lower at iso-work in patients with IC/TLC 25% than in those with IC/TLC >25%. Resting hyperinflation (IC/TLC) is associated with lower O2 pulse, peak exercise IC/TLC and exercise capacity in patients with severe COPD. Our results support an interaction between hyperinflation and decreased cardiac function that may contribute to exercise limitation in these patients.
Keywords:
Chronic obstructive pulmonary disease, exercise, inspiratory capacity, inspiratory capacity to total lung capacity ratio, oxygen pulse, oxygen uptake
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Copyright © 2008 by the European Respiratory Society.
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