Research Article
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Comparison of Cardiopulmonary Exercise Tests for Patients with COPD and Overlap Syndrome

Year 2019, Volume: 45 Issue: 3, 271 - 274, 01.12.2019
https://doi.org/10.32708/uutfd.620283

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a disease that progresses through inflammation and the main reason for morbidity in COPD is this inflammation. The rate of appearance of OS (Overlap Syndrome) and COPD together is %1 in the general public. Systemic inflammation increases the severity even more when the two diseases appear together. This is why the morbidity and mortality rates are higher with patients diagnosed with OS. The purpose of this study is to find out whether there is a significant difference between the cardiopulmonary exercise test results for patients with the COPD and Overlap Syndrome (OS). 18 patients were subjected to Cardiopulmonary Exercise Tests (CPET) within the scope of the study. 12 of the patients were diagnosed with COPD and 6 of them with OS. A symptom-limited incremental CPET was performed using a Vmax Encore, USA device. Informed consent was obtained from all subjects. The results of the CPET revealed that the maximum oxygen consumption (VO2max ml/kg/min) in the group of patients with COPD was 15,5 ±6,4,  and 12,4±6 in the group with OS. There was no significant difference in that sense (p>0,05). There was also no significant difference in carbon dioxide outturn between the two groups (VCO2 L/min) (p>0,05). The maximum work-watt in the group of patients with COPD was 59,2±29, and 45,8±19 in the group with OS. There also was no significant difference between these results (p>0,05).  The maximum throb of the group of patients diagnosed with COPD was 120±21, and 116±18 in the group with OS. The comparison of Oxygen pulse value (ml/Pulse) and maximum throb did not show any significant difference either (p>0,05). The maximum ventilation rate (VEmax-L/min) in the group of patients with COPD was 43±13, and 36,6±9,2 in the group with OS. No significant difference was found between the two groups. (p>0,05).  End-tidal CO2 values and end-tidal O2 values did not show any significant difference either. When compared (p >0,05). The respiratory quotient RQ in the group with COPD was 1,1 ±0,4 whereas in the group with OS the value was 1,1±0,4. No significant difference. The anaerobic thresold (AT) values in both groups were similar. No statistically significant difference was found between these two values either. (p>0,05). Although the CPET values of patients diagnosed with COPD and OSD were below the general population, there were no significant differences between the two diseases. 

References

  • 1. McNicholas WT. Chronic obstructive pulmonary disease and obstructivesleep apnea: Overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med. 2009;180:692–700
  • 2. Chaouat A, Weitzenblum E, Krieger J, et. al. Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med. 1995;151:82–86.
  • 3. Lee R, McNicholas WT. Obstructive sleep apnea in chronic obstructivepulmonary disease patients. Curr Opin Pulm Med. 2011;17:79–83.
  • 4. Marin JM, Soriano JB, Carrizo SJ, et. al. Outcomes in patients with chronic obstructive pulmonary disease and obstructivesleep apne. The overlap syndrome. Am J Respir Crit Care Med. 2010;182:325–331.
  • 5. Cooper CB, Storer TW. Exercise testing and interpretation: a practical approach. London: Cambridge University Press; 2001.
  • 6. American Thoracic Society; American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003;167:211-77
  • 7. Gallagher CG, Younes M. Breathing pattern during and after maximal exercise in patients with chronic obstructive lung disease, interstitial lung disease, and cardiac disease, and in normal subjects. Am Rev Respir Dis 1986;133:581-6.
  • 8. Belman MJ, Brooks LR, Ross DJ, et. al. Variability of breathlessness measurement in patients with chronic obstructive pulmonary disease. Chest 1991;99: 566–71.
  • 9. O’Donnell DE, D’Arsigny C, Webb KA. Effects of hyperoxia on ventilatory limitation during exercise in advanced chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;163:892-8.
  • 10. O’Donnell DE, D’Arsigny C, Fitzpatrick M, et. al. Exercise hypercapnia in advanced chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002;166:663–8.
  • 11. Efremidis G, Tsiamita M, Manolis A, et. al. Accuracy of pulmonary function tests in predicted exercise capacity in COPD patients. Respir Med 2005;99:609-14.
  • 12. Ulubay G, Eyüboğlu Öner F, Şimşek A, et. al. Cardiopulmonary exercise testing in the early diagnosis of COPD. Turk Respir J 2006;7:39-42.
  • 13. O’Donnell. Ventilatory limitations in chronic obstructive pulmonary disease Medicine & Science in Sports & Exercise; 2001: 647-55.
  • 14. Peppard P.E., Young T. Exercise and sleep-disordered breathing: an association independent of body habitus. Sleep 2004; 27: 480–484.
  • 15. Lin C, Hsieh W, Chou C, et. al. Cardiopulmonary exercise testing in obstructive sleep apnea syndrome. Respiratory Physiology & Neurobiology 2006;150: 27–34.
  • 16. Nanas S, Sakellariou D, Kapsimalakou S, et. al. Heart Rate Recovery and Oxygen Kinetics After Exercise in Obstructive Sleep Apnea Syndrome. Clin.Cardiol.33,1,46–51(2010)

KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi

Year 2019, Volume: 45 Issue: 3, 271 - 274, 01.12.2019
https://doi.org/10.32708/uutfd.620283

Abstract

Kronik Obstrüktif Akciğer Hastalığı (KOAH) sistemik inflamasyon ile seyreden bir hastalıktır ve sistemik inflamasyon KOAH’ta morbidite ve mortalitenin ana nedenidir. OSAS ve KOAH birlikteliği yani Overlap Sendromu (OS) toplumda % 1 sıklığında görülmektedir. Bu iki hastalığın birlikteliğinde sistemik inflamasyon şiddeti daha da artmaktadır. Bu nedenle de OS’lı hastalarda  morbidite ve mortalite  daha fazla oranda görülmektedir. Bu çalışmanın amacı KOAH ve OS’li hastalarda kardiyopulmoner egzersiz testleri arasında anlamlı farklılık olup olmadığını saptamaktı. Çalışmamızda 18 hastaya Kardiyopulmoner Egzersiz Testi (KPET) yapılmıştır. Test yapılan hastaların 12’si KOAH’lı ve 6’sı OS’lu idi. Çalışmaya alınan hastalara Vmax Encore, USA cihazı kullanılarak semptom sınırlı incremental KPET uygulandı. KPET sonucu maksimum oksijen tüketimi  (VO2max ml/kg/min) KOAH’lı grupta 15,5 ±6,4, OS’lı grupta 12,4±6 saptandı. Bu açıdan anlamlı fark yoktu (P>0,05). Karbondioksit üretimi (VCO2 L/min) açısıdan da iki grup arasında anlamlı fark saptanmadı (p>0,05). Maksimum iş kapasitesi (work-watt) KOAH’lı grupta 59,2±29, OS’lı grupta 45,8±19 saptadı. Bu değerler arasında da anlamlı fark saptanmadı (p>0,05).  Hastaların maksimum kalp hızı dakikada KOAH’lı grupta 120±21 ,OS’lı grupta 116±18 olarak saptandı. Oksijen pulse değeri (ml/atım) ve maksimum kalp hızı açısından İki grup karşılaştırmasında anlamlı fark yoktu (p>0,05) .Maksimum ventilasyon oranı (VEmax-L/dk) KOAH’lı grupta 43±13, OS’lı grupta 36,6±9,2 olarak saptadı. İki grup arasında anlamı fark saptanmadı (p>0,05).  Endtidal CO2 değeri  ve Endtidal O2 değeri açısında KOAH’lı ve OS’lı grup karşılaştırıldığında anlamlı fark saptanmadı (p >0,05) . Solunum katsayısı yani RQ oranı KOAH’lı grupta 1,1 ±0,4 iken OS’lı grupta 1,1±0,4 saptandı. İki grupta anlamlı fark yoktu. Anaerobik treeshot (AT) değeri KOAH’lı ve OS’lı grupta benzerdi. Bu değerler arasında da istatistiksel  anlamlı fark saptanmadı (p>0,05). Sonuç olarak değerlendirildiğinde KOAH ve OS’lu hastalarda KPET değerlerini normal popülasyona göre düşük saptamakla birlikte iki hastalık arasında anlamlı farklılık saptamadık.

References

  • 1. McNicholas WT. Chronic obstructive pulmonary disease and obstructivesleep apnea: Overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med. 2009;180:692–700
  • 2. Chaouat A, Weitzenblum E, Krieger J, et. al. Association of chronic obstructive pulmonary disease and sleep apnea syndrome. Am J Respir Crit Care Med. 1995;151:82–86.
  • 3. Lee R, McNicholas WT. Obstructive sleep apnea in chronic obstructivepulmonary disease patients. Curr Opin Pulm Med. 2011;17:79–83.
  • 4. Marin JM, Soriano JB, Carrizo SJ, et. al. Outcomes in patients with chronic obstructive pulmonary disease and obstructivesleep apne. The overlap syndrome. Am J Respir Crit Care Med. 2010;182:325–331.
  • 5. Cooper CB, Storer TW. Exercise testing and interpretation: a practical approach. London: Cambridge University Press; 2001.
  • 6. American Thoracic Society; American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003;167:211-77
  • 7. Gallagher CG, Younes M. Breathing pattern during and after maximal exercise in patients with chronic obstructive lung disease, interstitial lung disease, and cardiac disease, and in normal subjects. Am Rev Respir Dis 1986;133:581-6.
  • 8. Belman MJ, Brooks LR, Ross DJ, et. al. Variability of breathlessness measurement in patients with chronic obstructive pulmonary disease. Chest 1991;99: 566–71.
  • 9. O’Donnell DE, D’Arsigny C, Webb KA. Effects of hyperoxia on ventilatory limitation during exercise in advanced chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;163:892-8.
  • 10. O’Donnell DE, D’Arsigny C, Fitzpatrick M, et. al. Exercise hypercapnia in advanced chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002;166:663–8.
  • 11. Efremidis G, Tsiamita M, Manolis A, et. al. Accuracy of pulmonary function tests in predicted exercise capacity in COPD patients. Respir Med 2005;99:609-14.
  • 12. Ulubay G, Eyüboğlu Öner F, Şimşek A, et. al. Cardiopulmonary exercise testing in the early diagnosis of COPD. Turk Respir J 2006;7:39-42.
  • 13. O’Donnell. Ventilatory limitations in chronic obstructive pulmonary disease Medicine & Science in Sports & Exercise; 2001: 647-55.
  • 14. Peppard P.E., Young T. Exercise and sleep-disordered breathing: an association independent of body habitus. Sleep 2004; 27: 480–484.
  • 15. Lin C, Hsieh W, Chou C, et. al. Cardiopulmonary exercise testing in obstructive sleep apnea syndrome. Respiratory Physiology & Neurobiology 2006;150: 27–34.
  • 16. Nanas S, Sakellariou D, Kapsimalakou S, et. al. Heart Rate Recovery and Oxygen Kinetics After Exercise in Obstructive Sleep Apnea Syndrome. Clin.Cardiol.33,1,46–51(2010)
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Respiratory Diseases
Journal Section Research Article
Authors

Arzu Ertem Cengiz This is me

Funda Coşkun

Ahmet Ursavaş

Publication Date December 1, 2019
Acceptance Date October 10, 2019
Published in Issue Year 2019 Volume: 45 Issue: 3

Cite

APA Ertem Cengiz, A., Coşkun, F., & Ursavaş, A. (2019). KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(3), 271-274. https://doi.org/10.32708/uutfd.620283
AMA Ertem Cengiz A, Coşkun F, Ursavaş A. KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi. Uludağ Tıp Derg. December 2019;45(3):271-274. doi:10.32708/uutfd.620283
Chicago Ertem Cengiz, Arzu, Funda Coşkun, and Ahmet Ursavaş. “KOAH Ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45, no. 3 (December 2019): 271-74. https://doi.org/10.32708/uutfd.620283.
EndNote Ertem Cengiz A, Coşkun F, Ursavaş A (December 1, 2019) KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45 3 271–274.
IEEE A. Ertem Cengiz, F. Coşkun, and A. Ursavaş, “KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi”, Uludağ Tıp Derg, vol. 45, no. 3, pp. 271–274, 2019, doi: 10.32708/uutfd.620283.
ISNAD Ertem Cengiz, Arzu et al. “KOAH Ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45/3 (December 2019), 271-274. https://doi.org/10.32708/uutfd.620283.
JAMA Ertem Cengiz A, Coşkun F, Ursavaş A. KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi. Uludağ Tıp Derg. 2019;45:271–274.
MLA Ertem Cengiz, Arzu et al. “KOAH Ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, vol. 45, no. 3, 2019, pp. 271-4, doi:10.32708/uutfd.620283.
Vancouver Ertem Cengiz A, Coşkun F, Ursavaş A. KOAH ve Overlap Sendromlu Hastalarda Kardiyopulmoner Egzersiz Testinin Değerlendirilmesi. Uludağ Tıp Derg. 2019;45(3):271-4.

ISSN: 1300-414X, e-ISSN: 2645-9027

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