title: Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET).
  
  
  METHODS
  The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base within Shanghai and referrals from centres in other cities as well.
  
  
  METHODS
  157 Chinese patients with stable severe COPD were divided into 2 groups: the anaemia group (haemoglobin (Hb) <12.0 g/dL for males, and <11 g/dL for females (n=48)) and the non-anaemia group (n=109).
  
  
  METHODS
  Arterial blood gas, PFT and CPET were tested in all patients.
  
  
  RESULTS
  (1) Diffusing capacity for carbon monoxide (DLCO) corrected by Hb was significantly lower in the anaemia group ((15.3±1.9) mL/min/mm Hg) than in the non-anaemia group ((17.1±2.1) mL/min/mm Hg) (p<0.05). A significant difference did not exist in the level of forced expiratory volume in 1 s (FEV1), FEV1%pred, FEV1/forced vital capacity (FVC), inspiratory capacity (IC), residual volume (RV), total lung capacity (TLC) and RV/TLC (p>0.05). (2) Peak Load, Peak oxygen uptake (VO2), Peak VO2%pred, Peak VO2/kg, Peak O2 pulse and the ratio of VO2 increase to WR increase (ΔVO2/ΔWR) were significantly lower in the anaemia group (p<0.05); however, Peak minute ventilation (VE), Lowest VE/carbon dioxide output (VCO2) and Peak dead space/tidal volume ratio (VD/VT) were similar between the 2 groups (p>0.05). (3) A strong positive correlation was found between Hb concentration and Peak VO2 in patients with anaemia (r=0.702, p<0.01).
  
  
  CONCLUSIONS
  Anaemia has a negative impact on gas exchange and exercise tolerance during exercise in patients with severe COPD. The decrease in amplitude of Hb levels is related to the quantity of oxygen uptake.
authors.affiliation: Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Respiratory Diseases, Shanghai Changning District Central Hospital, Shanghai, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Zheng
authors.affiliation: Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xiao
authors.affiliation: Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Sugang
authors.initials: S
authors.lastname: Gong
authors.affiliation: Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Qinhua
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Wenlan
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Shi
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Heart-Lung Function Testing Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Xingguo
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jinming
authors.initials: J
authors.lastname: Liu
mesh_terms: D000740:Anemia / Q000097:blood / Q000150:complications*; D001784:Blood Gas Analysis; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins
keywords: anemia; cardiopulmonary exercise test; chronic obstructive pulmonary disease; hemoglobin