Decreased left ventricular stroke volume is associated with low-grade exercise tolerance in patients with chronic obstructive pulmonary disease.
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 (FEV1) 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.
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Sumito
S
Inoue
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Yoko
Y
Shibata
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Hiroyuki
H
Kishi
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Joji
J
Nitobe
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Tadateru
T
Iwayama
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Yoshinori
Y
Yashiro
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Takako
T
Nemoto
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Kento
K
Sato
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Masamichi
M
Sato
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Tomomi
T
Kimura
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Akira
A
Igarashi
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Yoshikane
Y
Tokairin
Department of Cardiology, Pulmonology, and Nephrology , Yamagata University School of Medicine , Yamagata , Japan.
Isao
I
Kubota
COPD Pathology; Exercise; Imaging/CT MRI etc