左心室每搏输出量降低与慢性阻塞性肺疾病患者的低水平运动耐量相关。
Decreased left ventricular stroke volume is associated with low-grade exercise tolerance in patients with chronic obstructive pulmonary disease.
作者信息
Inoue Sumito, Shibata Yoko, Kishi Hiroyuki, Nitobe Joji, Iwayama Tadateru, Yashiro Yoshinori, Nemoto Takako, Sato Kento, Sato Masamichi, Kimura Tomomi, Igarashi Akira, Tokairin Yoshikane, Kubota Isao
机构信息
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
出版信息
BMJ Open Respir Res. 2017 Jan 25;4(1):e000158. doi: 10.1136/bmjresp-2016-000158. eCollection 2017.
BACKGROUND
Low-grade exercise tolerance is associated with a poor prognosis in patients with chronic obstructive pulmonary disease (COPD). The 6 min walk test (6MWT) is commonly used to evaluate exercise tolerance in patients with COPD. However, little is known regarding the relationship between cardiac function and exercise tolerance in patients with COPD. The aim of this study was to identify predictive factors in cardiac function for low-grade exercise tolerance in patients with stable COPD.
METHODS
We recruited 57 patients with stable COPD (men 54, women 3) to perform the 6MWT. Patients with underlying orthopaedic disease or heart failure were excluded. Cardiac function was evaluated by echocardiography and contrast-enhanced cardiac CT. We also measured pulmonary function and the 6MWT distance.
RESULTS
Forced expiratory volume in 1 s (FEV) and per cent predicted FEV, along with left ventricular end diastolic volume and left ventricular cardiac output as measured by cardiac CT, were significantly related to the 6MWT distance. On multivariate analysis, left ventricular stroke volume was the factor most closely associated with a decreased walked distance in the 6MWT.
CONCLUSIONS
Decreased left ventricular stroke volume was associated with low-grade exercise tolerance in patients with stable COPD without heart failure.
背景
运动耐量低下与慢性阻塞性肺疾病（COPD）患者的不良预后相关。6分钟步行试验（6MWT）常用于评估COPD患者的运动耐量。然而，关于COPD患者心功能与运动耐量之间的关系知之甚少。本研究的目的是确定稳定期COPD患者运动耐量低下的心功能预测因素。
方法
我们招募了57例稳定期COPD患者（男性54例，女性3例）进行6MWT。排除患有潜在骨科疾病或心力衰竭的患者。通过超声心动图和对比增强心脏CT评估心功能。我们还测量了肺功能和6MWT距离。
结果
1秒用力呼气容积（FEV）和预测FEV百分比，以及心脏CT测量的左心室舒张末期容积和左心室心输出量，与6MWT距离显著相关。多因素分析显示，左心室每搏输出量是与6MWT步行距离缩短最密切相关的因素。
结论
左心室每搏输出量降低与无心力衰竭的稳定期COPD患者运动耐量低下有关。
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