Journal article
Right ventricular diastolic function and exercise capacity in COPD
Respiratory medicine, Vol.109(10), pp.1287-1292
10/2015
DOI: 10.1016/j.rmed.2015.09.003
PMCID: PMC4745988
PMID: 26371994
Abstract
Decreased exercise capacity in chronic obstructive pulmonary disease (COPD) is incompletely explained by pulmonary pathologic and physiologic abnormalities. We evaluated the extent to which right ventricular diastolic function (RVDF) is associated with exercise capacity in COPD.
Fifty-one patients with COPD were evaluated by echocardiography, spirometry, and the 6 min walk test (6MWT). RVDF was assessed using 4 echocardiographic parameters: 1) the ratio of tricuspid valve (TV) early (E) and late (A) inflow velocities (TV E/A) 2) TV early tissue Doppler velocity (TV e′) 3) TV deceleration time (DT) and 4) the ratio of TV E and e′ velocities (TV E/e′). Multiple linear regression was used to examine the extent to which these parameters were associated with 6MWT distance. All models adjusted for age, sex, post-bronchodilator FEV1/FVC, resting heart rate, and use of supplemental O2 during 6MWT. A regression model was calculated for each of the 4 markers of RVDF.
Forty-seven percent of the sample had GOLD stage III or IV COPD. All 51 subjects had preserved left ventricular ejection fraction (LVEF, mean = 71.7%, SD = 7.8%). A higher TV E/A ratio was associated with increased 6MWT distance (p = 0.001). TV e′, TV DT and TV E/e′ did not have a statistically significant association with 6MWT distance in regression models.
In a cohort with moderate to severe COPD and normal LVEF, TV E/A was associated with 6MWT distance after adjusting for relevant demographic and medical covariates. RV diastolic dysfunction may independently contribute to exercise intolerance in COPD.
•Right ventricular diastolic function (RVDF) may contribute to exercise tolerance.•COPD patients were evaluated by echocardiography and 6 min walk test (6MWT).•RVDF was assessed using the ratio of early:late tricuspid valve velocities (TV E/A).•Increased TV E/A ratio was associated with increased 6MWT distance.
Details
- Title: Subtitle
- Right ventricular diastolic function and exercise capacity in COPD
- Creators
- Brett E Fenster - National Jewish Health, Division of Cardiology, Denver, CO, United StatesKristen E Holm - National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United StatesHoward D Weinberger - National Jewish Health, Division of Cardiology, Denver, CO, United StatesKerrie L Moreau - University of Colorado School of Medicine at the Anschutz Medical Campus, Department of Medicine, Aurora, CO, United StatesKimberly Meschede - National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United StatesJames D Crapo - National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United StatesBarry J Make - National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United StatesRussell Bowler - National Jewish Health, Division of Pulmonary, Critical Care and Sleep Medicine, Denver, CO, United StatesFrederick S Wamboldt - University of Colorado School of Medicine at the Anschutz Medical Campus, Department of Psychiatry, Aurora, CO, United StatesKarin F Hoth - University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Respiratory medicine, Vol.109(10), pp.1287-1292
- DOI
- 10.1016/j.rmed.2015.09.003
- PMID
- 26371994
- PMCID
- PMC4745988
- NLM abbreviation
- Respir Med
- ISSN
- 0954-6111
- eISSN
- 1532-3064
- Publisher
- Elsevier Ltd
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: K23 HL095658, R01 HL089897; DOI: 10.13039/100006108, name: NCATS, award: UL1 TR001082
- Language
- English
- Date published
- 10/2015
- Academic Unit
- Psychiatry; Iowa Neuroscience Institute
- Record Identifier
- 9984066382802771
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