Comparison of cardiopulmonary exercise testing variables in COPD patients with and without coronary artery disease

Wilawan Thirapatarapong, Hilary F. Armstrong, Matthew N. Bartels

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Coronary artery disease (CAD) is a common concomitant condition and an important cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Since COPD and CAD can both independently cause reduced exercise capacity, it is reasonable to hypothesize that the combination of these diseases may compound the abnormalities observed during cardiopulmonary exercise testing (CPET). However, little is known about the impact of CAD on the CPET response in COPD patients. The aim of this study is to compare exercise capacity and gas exchange variables in COPD patients with and without CAD. Methods: Fifty-four COPD subjects without CAD (COPDnoCAD) were matched to 54 COPD subjects diagnosed with CAD (COPD/CAD) according to age, gender, body mass index and severity of COPD. All subjects underwent resting pulmonary function and symptom-limited CPET. Results: Comparing COPDnoCAD patients with COPD/CAD patients revealed that exercise capacity, as measured by % peak oxygen consumption (42±16% vs 53±19%, p=0.002) and % peak wattage (23±13% vs 32±16%, p=0.001), was significantly lower in COPD/CAD. Ventilatory response, as measured by VE/VCO2 nadir (36±9 vs 32±5, p=0.001), was significantly higher in COPD/CAD, with % peak VO2 and VE/VCO2 nadir correlating to % FEV1 and inversely correlating with %DLCO. Conclusion: COPD patients with CAD have significantly impaired CPET responses with lower exercise capacity and impaired gas exchange compared to COPD patients without CAD. These findings may affect the clinical interpretation of CPET data in COPD patients who have concomitant CAD.

Original languageEnglish (US)
Pages (from-to)146-151
Number of pages6
JournalHeart and Lung: Journal of Acute and Critical Care
Volume43
Issue number2
DOIs
StatePublished - Mar 2014
Externally publishedYes

Fingerprint

Chronic Obstructive Pulmonary Disease
Coronary Artery Disease
Exercise
Gases
Oxygen Consumption
Pulmonary Artery
Body Mass Index
Morbidity
Lung

Keywords

  • COPD
  • Coronary artery disease
  • Exercise capacity
  • Ventilatory efficiency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Critical Care and Intensive Care Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Comparison of cardiopulmonary exercise testing variables in COPD patients with and without coronary artery disease. / Thirapatarapong, Wilawan; Armstrong, Hilary F.; Bartels, Matthew N.

In: Heart and Lung: Journal of Acute and Critical Care, Vol. 43, No. 2, 03.2014, p. 146-151.

Research output: Contribution to journalArticle

@article{0ee1ddc648f04dc8b732f278a4837b50,
title = "Comparison of cardiopulmonary exercise testing variables in COPD patients with and without coronary artery disease",
abstract = "Background: Coronary artery disease (CAD) is a common concomitant condition and an important cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Since COPD and CAD can both independently cause reduced exercise capacity, it is reasonable to hypothesize that the combination of these diseases may compound the abnormalities observed during cardiopulmonary exercise testing (CPET). However, little is known about the impact of CAD on the CPET response in COPD patients. The aim of this study is to compare exercise capacity and gas exchange variables in COPD patients with and without CAD. Methods: Fifty-four COPD subjects without CAD (COPDnoCAD) were matched to 54 COPD subjects diagnosed with CAD (COPD/CAD) according to age, gender, body mass index and severity of COPD. All subjects underwent resting pulmonary function and symptom-limited CPET. Results: Comparing COPDnoCAD patients with COPD/CAD patients revealed that exercise capacity, as measured by {\%} peak oxygen consumption (42±16{\%} vs 53±19{\%}, p=0.002) and {\%} peak wattage (23±13{\%} vs 32±16{\%}, p=0.001), was significantly lower in COPD/CAD. Ventilatory response, as measured by VE/VCO2 nadir (36±9 vs 32±5, p=0.001), was significantly higher in COPD/CAD, with {\%} peak VO2 and VE/VCO2 nadir correlating to {\%} FEV1 and inversely correlating with {\%}DLCO. Conclusion: COPD patients with CAD have significantly impaired CPET responses with lower exercise capacity and impaired gas exchange compared to COPD patients without CAD. These findings may affect the clinical interpretation of CPET data in COPD patients who have concomitant CAD.",
keywords = "COPD, Coronary artery disease, Exercise capacity, Ventilatory efficiency",
author = "Wilawan Thirapatarapong and Armstrong, {Hilary F.} and Bartels, {Matthew N.}",
year = "2014",
month = "3",
doi = "10.1016/j.hrtlng.2013.12.005",
language = "English (US)",
volume = "43",
pages = "146--151",
journal = "Heart and Lung: Journal of Acute and Critical Care",
issn = "0147-9563",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Comparison of cardiopulmonary exercise testing variables in COPD patients with and without coronary artery disease

AU - Thirapatarapong, Wilawan

AU - Armstrong, Hilary F.

AU - Bartels, Matthew N.

PY - 2014/3

Y1 - 2014/3

N2 - Background: Coronary artery disease (CAD) is a common concomitant condition and an important cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Since COPD and CAD can both independently cause reduced exercise capacity, it is reasonable to hypothesize that the combination of these diseases may compound the abnormalities observed during cardiopulmonary exercise testing (CPET). However, little is known about the impact of CAD on the CPET response in COPD patients. The aim of this study is to compare exercise capacity and gas exchange variables in COPD patients with and without CAD. Methods: Fifty-four COPD subjects without CAD (COPDnoCAD) were matched to 54 COPD subjects diagnosed with CAD (COPD/CAD) according to age, gender, body mass index and severity of COPD. All subjects underwent resting pulmonary function and symptom-limited CPET. Results: Comparing COPDnoCAD patients with COPD/CAD patients revealed that exercise capacity, as measured by % peak oxygen consumption (42±16% vs 53±19%, p=0.002) and % peak wattage (23±13% vs 32±16%, p=0.001), was significantly lower in COPD/CAD. Ventilatory response, as measured by VE/VCO2 nadir (36±9 vs 32±5, p=0.001), was significantly higher in COPD/CAD, with % peak VO2 and VE/VCO2 nadir correlating to % FEV1 and inversely correlating with %DLCO. Conclusion: COPD patients with CAD have significantly impaired CPET responses with lower exercise capacity and impaired gas exchange compared to COPD patients without CAD. These findings may affect the clinical interpretation of CPET data in COPD patients who have concomitant CAD.

AB - Background: Coronary artery disease (CAD) is a common concomitant condition and an important cause of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Since COPD and CAD can both independently cause reduced exercise capacity, it is reasonable to hypothesize that the combination of these diseases may compound the abnormalities observed during cardiopulmonary exercise testing (CPET). However, little is known about the impact of CAD on the CPET response in COPD patients. The aim of this study is to compare exercise capacity and gas exchange variables in COPD patients with and without CAD. Methods: Fifty-four COPD subjects without CAD (COPDnoCAD) were matched to 54 COPD subjects diagnosed with CAD (COPD/CAD) according to age, gender, body mass index and severity of COPD. All subjects underwent resting pulmonary function and symptom-limited CPET. Results: Comparing COPDnoCAD patients with COPD/CAD patients revealed that exercise capacity, as measured by % peak oxygen consumption (42±16% vs 53±19%, p=0.002) and % peak wattage (23±13% vs 32±16%, p=0.001), was significantly lower in COPD/CAD. Ventilatory response, as measured by VE/VCO2 nadir (36±9 vs 32±5, p=0.001), was significantly higher in COPD/CAD, with % peak VO2 and VE/VCO2 nadir correlating to % FEV1 and inversely correlating with %DLCO. Conclusion: COPD patients with CAD have significantly impaired CPET responses with lower exercise capacity and impaired gas exchange compared to COPD patients without CAD. These findings may affect the clinical interpretation of CPET data in COPD patients who have concomitant CAD.

KW - COPD

KW - Coronary artery disease

KW - Exercise capacity

KW - Ventilatory efficiency

UR - http://www.scopus.com/inward/record.url?scp=84896849410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896849410&partnerID=8YFLogxK

U2 - 10.1016/j.hrtlng.2013.12.005

DO - 10.1016/j.hrtlng.2013.12.005

M3 - Article

VL - 43

SP - 146

EP - 151

JO - Heart and Lung: Journal of Acute and Critical Care

JF - Heart and Lung: Journal of Acute and Critical Care

SN - 0147-9563

IS - 2

ER -