Abstract
Background: Autonomic dysfunction (AD) and cardio-pulmonary exercise testing (CPET) parameters have been associated with masked heart failure with preserved ejection fraction (HFpEF) in the general population. Their clinical significance for masked HFpEF in chronic obstructive pulmonary disease (COPD) is however elusive.
Aims and Objectives: The aim of the study was to determine the prevalence, correlation and clinical significance of AD and CPET with masked HFpEF, in non-severe COPD patients, complaining of exertional dyspnea, without clinically overt cardio-vascular (CV) comorbidities.
Methods: We applied CPET in 68 COPD subjects. Echocardiography was performed before CPET and 1-2 minutes after peak exercise. Patients were divided into: patients with and without masked HFpEF. Peak E/e’ - 15 was applied as a cut-off. Chronotropic incompetence was assumed based on the Wilkoff formula. Abnormal HR recovery (HRR) was taken if the decline is less than 12 beats within the first minute after exercise cessation.
Results: Univariate regression showed association between masked HFpEF, HRR, ’VO2, ’VO2 at AT, oxygen pulse and ’VE/’VCO2 slope. The multivariate regression demonstrated HRR as the only independent predictor of masked HFpEF – (OR 10.28; 95% CI (3.55-29.80)).
Conclusions: Abnormal HRR is the only independent predictor of masked HFpEF in non-severe COPD patients. Despite of being associated with masked HFpEF, the lower ’VO2, lower oxygen pulse, higher ’VE/’VCO2 slope and lower exercise load seem to be the consequences, rather than the triggers for it.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3767.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020