Myocardial performance index correlates with the BODE index and affects quality of life in COPD patients.
OBJECTIVE
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.


METHODS
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).


RESULTS
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 (r2=0.47;P<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 (P=0.005). These patients had a 1.49-fold increased risk of exhibiting SGRQ total score above the upper limit of the 95% CI (P=0.01).


CONCLUSIONS
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.
Faculty of Medicine, Federal University of Goias, Goiânia, Goiás.
Daniela Graner Schuwartz
DG
Tannus-Silva
Faculty of Medicine, Federal University of Goias, Goiânia, Goiás.
João Batista
JB
Masson-Silva
Faculty of Medicine, Federal University of Goias, Goiânia, Goiás.
Lays Silva
LS
Ribeiro
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.
Marcus Barreto
MB
Conde
Faculty of Medicine, Federal University of Goias, Goiânia, Goiás.
Marcelo Fouad
MF
Rabahi
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D013147:Spirometry; D011795:Surveys and Questionnaires; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000523:psychology; D016278:Ventricular Function, Right; D000070857:Walk Test
D015415:Biomarkers; D010100:Oxygen
BODE score; COPD; echocardiography; quality of life; right ventricle dysfunction
Tuberk Toraks. 2004;52(1):52-5
15143373
Clin Cardiol. 2015 Dec;38(12):770-6
26289321
J Am Coll Cardiol. 2013 Sep 17;62(12 ):1103-11
23831444
COPD. 2016 Jun;13(3):345-51
26682932
Chest. 1999 Dec;116(6):1632-7
10593787
Eur Respir J. 2009 May;33(5):1165-85
19407051
Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
12091180
PLoS One. 2015 Jul 13;10(7):e0132670
26168154
J Am Soc Echocardiogr. 2010 Jul;23 (7):685-713; quiz 786-8
20620859
Am J Respir Crit Care Med. 1998 May;157(5 Pt 1):1418-22
9603117
Am J Med. 1966 Jul;41(1):115-29
5328350
BMC Pulm Med. 2014 Apr 25;14:70
24762026
Am Rev Respir Dis. 1973 Dec;108(6):1373-83
4751722
Chest. 2005 Jun;127(6):1898-903
15947300
Circ Cardiovasc Imaging. 2015 Jun;8(6):null
26063743
J Bras Pneumol. 2007 Jul-Aug;33(4):397-406
17982531
Health Qual Life Outcomes. 2005 Sep 09;3:56
16153294
Respiration. 2014;88(3):223-33
25139573
Arch Bronconeumol. 2015 Jul;51(7):315-21
25622995
PLoS One. 2011;6(12 ):e29069
22220201
Proc Am Thorac Soc. 2008 May 1;5(4):513-8
18453364
J Am Soc Echocardiogr. 2002 Jun;15(6):633-9
12050605
Eur Respir J. 2008 Oct;32(4):962-9
18579551
Respir Care. 2013 May;58(5):816-23
23051582
N Engl J Med. 2004 Mar 4;350(10):1005-12
14999112
Thorax. 1981 Oct;36(10):752-8
7330793
Ann Intern Med. 1997 Dec 15;127(12):1072-9
9412309
Int J Chron Obstruct Pulmon Dis. 2006;1(1):3-14
18046898
Eur Respir J. 2006 Apr;27(4):689-96
16585077
Respir Med. 2015 Oct;109 (10 ):1287-92
26371994