Tannus-Silva Daniela Graner Schuwartz, Masson-Silva João Batista, Ribeiro Lays Silva, Conde Marcus Barreto, Rabahi Marcelo Fouad
Faculty of Medicine, Federal University of Goias, Goiânia, Goiás.
Instituto de Doenças do Tórax da Universidade Federal do Rio de Janeiro, Rio de Janeiro; Faculdade de Medicina de Petrópolis, Petrópolis, Rio de Janeiro, Brazil.
Int J Chron Obstruct Pulmon Dis. 2016 Sep 16;11:2261-2268. doi: 10.2147/COPD.S110779. eCollection 2016.
COPD, a systemic illness associated with the impairment of different organs, affects patient prognosis and quality of life. The aim of this study was to evaluate the association between right ventricle (RV) function, the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (a multifunctional scale for the assessment of mortality risk), and quality of life in patients with COPD.
A cross-sectional study was carried out in 107 outpatients presenting with stable COPD who underwent clinical assessment, spirometry, arterial blood gas analyses, a 6-minute walk test, electrocardiography, and echocardiogram and who responded to the Saint George's Respiratory Questionnaire (SGRQ).
Among the study subjects, 53% (57/107) were males, and the mean age was 65.26±8.81 years. A positive correlation was observed between RV dysfunction measured by the myocardial performance index using tissue Doppler (MPIt) and the BODE index, even after adjustment for age and partial pressure of oxygen (=0.47; <0.01). Patients with alterations in the MPIt had worse quality of life, and a statistically significant difference was found for different domains of the SGRQ. Patients with a normal MPIt had a mean total score of 46.2±18.6, whereas for those with MPIt alterations, the mean total score was 61.6±14.2 (=0.005). These patients had a 1.49-fold increased risk of exhibiting SGRQ total score above the upper limit of the 95% CI (=0.01).
The findings of this study suggest that RV dysfunction as measured by the MPIt was associated with impairment in quality of life and a worse BODE index in COPD patients, irrespective of age and hypoxemia status.
慢性阻塞性肺疾病(COPD)是一种与不同器官功能受损相关的全身性疾病,会影响患者的预后和生活质量。本研究的目的是评估慢性阻塞性肺疾病患者右心室(RV)功能、BODE(体重指数、气流阻塞、呼吸困难和运动能力)指数(一种用于评估死亡风险的多功能量表)与生活质量之间的关联。
对107例稳定期慢性阻塞性肺疾病门诊患者进行了横断面研究,这些患者接受了临床评估、肺功能检查、动脉血气分析、6分钟步行试验、心电图检查和超声心动图检查,并对圣乔治呼吸问卷(SGRQ)做出了回应。
在研究对象中,53%(57/107)为男性,平均年龄为65.26±8.81岁。即使在调整年龄和氧分压后,使用组织多普勒测量的心肌性能指数(MPIt)所测得的右心室功能障碍与BODE指数之间仍存在正相关(=0.47;<0.01)。MPIt异常的患者生活质量较差,在SGRQ的不同领域发现了统计学上的显著差异。MPIt正常的患者平均总分为46.2±18.6,而MPIt异常的患者平均总分为61.6±14.2(=0.005)。这些患者的SGRQ总分高于95%CI上限的风险增加了1.49倍(=0.01)。
本研究结果表明,无论年龄和低氧血症状态如何,用MPIt测量的右心室功能障碍与慢性阻塞性肺疾病患者的生活质量受损和更差的BODE指数相关。