Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.

<h4>Background</h4>Exercise capacity is an important feature in patients with COPD. Its impairment drives disability and dependency for daily activities performance. This study evaluated the six years change in exercise capacity in subjects with airflow obstruction and compared this to s...

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Main Authors: Fernanda Machado Rodrigues, Matthias Loeckx, Miek Hornikx, Hans Van Remoortel, Zafeiris Louvaris, Heleen Demeyer, Wim Janssens, Thierry Troosters
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0208841
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author Fernanda Machado Rodrigues
Matthias Loeckx
Miek Hornikx
Hans Van Remoortel
Zafeiris Louvaris
Heleen Demeyer
Wim Janssens
Thierry Troosters
author_facet Fernanda Machado Rodrigues
Matthias Loeckx
Miek Hornikx
Hans Van Remoortel
Zafeiris Louvaris
Heleen Demeyer
Wim Janssens
Thierry Troosters
author_sort Fernanda Machado Rodrigues
collection DOAJ
description <h4>Background</h4>Exercise capacity is an important feature in patients with COPD. Its impairment drives disability and dependency for daily activities performance. This study evaluated the six years change in exercise capacity in subjects with airflow obstruction and compared this to subjects without airflow obstruction, with and without a smoking history.<h4>Methods</h4>Cardiopulmonary exercise tests (CPET) were repeatedly performed during a six years follow up period. Peak oxygen uptake (VO2peak), work rate (WRpeak), heart rate (HRpeak), minute ventilation (VEpeak), respiratory exchange ratio (RERpeak) and ventilatory reserve (VE/MVV) were collected as effort dependent outcomes. The slopes of oxygen uptake, ventilatory and mechanical efficiency (OUES, ΔVE/ΔVCO2 and ΔVO2/ΔWR) were collected as effort independent outcomes.<h4>Results</h4>One hundred and thirty-eight subjects were included. Thirty-eight presented airflow obstruction (63±6 years, 74% men, FEV1 90±15%pred), 44 had a smoking history but no airflow obstruction (61±5 years, 61% men, FEV1 105±15%pred) and 56 had never smoked (61±7 years, 57% men, FEV1 117±18%pred). At baseline, the airflow obstruction group had slightly worse exercise capacity in comparison to the never smoking control group, in absolute terms and expressed as percentage of the predicted value (VO2peak = 27±5 versus 32±8 ml/min/kg, p<0.01; 112±29 versus 130±33%pred, p = 0.04). Most exercise variables showed a statistically significant yearly deterioration, with exception of VE/MVV, ΔVE/ΔVCO2 and ΔVO2/ΔWR. The yearly decline in VO2peak and OUES was not faster in subjects with airflow obstruction than in smoking and never smoking controls (VO2peak -67 (9) versus -76 (9) ml/min, p = 0.44 and versus -58 (9), p = 0.47; OUES -32 (11) versus -68 (10), p = 0.03 and versus -68 (13), p = 0.03).<h4>Conclusions</h4>With exception of VO2peak, effort dependent variables deteriorated faster in subjects with airflow obstruction compared to never smoking controls. The deterioration of effort independent variables, however, was not accelerated in the airflow obstruction group compared to controls.
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spelling doaj.art-af81d5fc4ada4f4ba862536c03f0ba772022-12-21T18:32:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011312e020884110.1371/journal.pone.0208841Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.Fernanda Machado RodriguesMatthias LoeckxMiek HornikxHans Van RemoortelZafeiris LouvarisHeleen DemeyerWim JanssensThierry Troosters<h4>Background</h4>Exercise capacity is an important feature in patients with COPD. Its impairment drives disability and dependency for daily activities performance. This study evaluated the six years change in exercise capacity in subjects with airflow obstruction and compared this to subjects without airflow obstruction, with and without a smoking history.<h4>Methods</h4>Cardiopulmonary exercise tests (CPET) were repeatedly performed during a six years follow up period. Peak oxygen uptake (VO2peak), work rate (WRpeak), heart rate (HRpeak), minute ventilation (VEpeak), respiratory exchange ratio (RERpeak) and ventilatory reserve (VE/MVV) were collected as effort dependent outcomes. The slopes of oxygen uptake, ventilatory and mechanical efficiency (OUES, ΔVE/ΔVCO2 and ΔVO2/ΔWR) were collected as effort independent outcomes.<h4>Results</h4>One hundred and thirty-eight subjects were included. Thirty-eight presented airflow obstruction (63±6 years, 74% men, FEV1 90±15%pred), 44 had a smoking history but no airflow obstruction (61±5 years, 61% men, FEV1 105±15%pred) and 56 had never smoked (61±7 years, 57% men, FEV1 117±18%pred). At baseline, the airflow obstruction group had slightly worse exercise capacity in comparison to the never smoking control group, in absolute terms and expressed as percentage of the predicted value (VO2peak = 27±5 versus 32±8 ml/min/kg, p<0.01; 112±29 versus 130±33%pred, p = 0.04). Most exercise variables showed a statistically significant yearly deterioration, with exception of VE/MVV, ΔVE/ΔVCO2 and ΔVO2/ΔWR. The yearly decline in VO2peak and OUES was not faster in subjects with airflow obstruction than in smoking and never smoking controls (VO2peak -67 (9) versus -76 (9) ml/min, p = 0.44 and versus -58 (9), p = 0.47; OUES -32 (11) versus -68 (10), p = 0.03 and versus -68 (13), p = 0.03).<h4>Conclusions</h4>With exception of VO2peak, effort dependent variables deteriorated faster in subjects with airflow obstruction compared to never smoking controls. The deterioration of effort independent variables, however, was not accelerated in the airflow obstruction group compared to controls.https://doi.org/10.1371/journal.pone.0208841
spellingShingle Fernanda Machado Rodrigues
Matthias Loeckx
Miek Hornikx
Hans Van Remoortel
Zafeiris Louvaris
Heleen Demeyer
Wim Janssens
Thierry Troosters
Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.
PLoS ONE
title Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.
title_full Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.
title_fullStr Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.
title_full_unstemmed Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.
title_short Six years progression of exercise capacity in subjects with mild to moderate airflow obstruction, smoking and never smoking controls.
title_sort six years progression of exercise capacity in subjects with mild to moderate airflow obstruction smoking and never smoking controls
url https://doi.org/10.1371/journal.pone.0208841
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