Mesquita Rafael, Franssen Frits M E, Houben-Wilke Sarah, Uszko-Lencer Nicole H M K, Vanfleteren Lowie E G W, Goërtz Yvonne M J, Pitta Fabio, Wouters Emiel F M, Spruit Martijn A
Department of Research & Education, CIRO, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands.
Department of Research & Education, CIRO, Horn, The Netherlands.
Int J Cardiol. 2016 Dec 15;225:365-370. doi: 10.1016/j.ijcard.2016.10.016. Epub 2016 Oct 11.
It remains unknown whether and to what extent impaired left ventricular ejection fraction (LVEF) affects physical and psychological status in COPD. We aimed to compare health outcome measures between COPD patients with and without impaired LVEF after adjusting for age, sex, BMI and FEV.
Impaired LVEF was defined as values <50%. 85 COPD patients with impaired LVEF and 85 COPD patients with normal LVEF were matched for sex, age, BMI and FEV. Exercise capacity, quadriceps muscle function, functional mobility, inflammatory status, health status, care dependency, and mood disorders were cross-sectionally assessed.
Patients with impaired LVEF had shorter 6-minute walk distance (mean -59 (95% confidence interval: -94, -25)m), lower symptom-limited peak oxygen uptake (-131 (-268, 7)ml/min), weaker quadriceps muscles (-12 (-20, -3)Nm) and had more symptoms of anxiety (+2 (1, 3) points) and depression (+1 (0, 2) points) than those with normal LVEF (all P<0.05). Health status was not statistically different between groups (P>0.05).
Impaired LVEF has a clear impact on physical and psychological status in patients with COPD, even after adjusting for confounders. This reinforces the importance of assessing and treating cardiac problems in COPD.
左心室射血分数（LVEF）受损是否以及在何种程度上影响慢性阻塞性肺疾病（COPD）患者的身体和心理状况尚不清楚。我们旨在比较在调整年龄、性别、体重指数（BMI）和第1秒用力呼气容积（FEV）后，LVEF受损和未受损的COPD患者的健康结局指标。
LVEF受损定义为值<50%。85例LVEF受损的COPD患者和85例LVEF正常的COPD患者在性别、年龄、BMI和FEV方面进行匹配。对运动能力、股四头肌功能、功能活动能力、炎症状态、健康状况、护理依赖和情绪障碍进行横断面评估。
与LVEF正常的患者相比，LVEF受损的患者6分钟步行距离更短（平均-59（95%置信区间：-94，-25）m），症状限制下的峰值摄氧量更低（-131（-268，7）ml/min），股四头肌更弱（-12（-20，-3）Nm），焦虑症状（+2（1，3）分）和抑郁症状（+1（0，2）分）更多（所有P<0.05）。两组间健康状况无统计学差异（P>0.05）。
即使在调整混杂因素后，LVEF受损对COPD患者的身体和心理状况仍有明显影响。这强化了评估和治疗COPD患者心脏问题的重要性。
