0
Clinical Investigations: COPD |

Exercise Capacity Deterioration in Patients With COPD*: Longitudinal Evaluation Over 5 Years

Toru Oga, MD; Koichi Nishimura, MD; Mitsuhiro Tsukino, MD; Susumu Sato, MD; Takashi Hajiro, MD; Michiaki Mishima, MD
Author and Funding Information

*From the Department of Respiratory Medicine (Drs. Oga, Sato, and Mishima), Graduate School of Medicine, Kyoto University, Kyoto; Respiratory Division (Dr. Nishimura), Kyoto-Katsura Hospital, Kyoto, Japan; Department of Respiratory Medicine (Dr. Tsukino), Hikone Municipal Hospital, Hikone, Japan; and Department of Cardiovascular and Respiratory Medicine (Dr. Hajiro), Shiga University of Medical Science, Otsu, Japan.

Correspondence to: Toru Oga, MD, Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 53, Kawahara, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan; e-mail: ogat@df7.so-net.ne.jp



Chest. 2005;128(1):62-69. doi:10.1378/chest.128.1.62
Text Size: A A A
Published online

Background: Although exercise capacity is an important outcome measure in patients with COPD, its longitudinal course has not been analyzed in comparison to the change in pulmonary function.

Purpose: To examine how exercise capacity would deteriorate over time in patients with COPD, and what factors would contribute to it.

Methods: A total of 137 male outpatients with moderate-to-very-severe COPD were examined. The average age was 69.0 ± 6.6 years (± SD), and the mean postbronchodilator FEV1 was 45.9 ± 15.4% predicted. Progressive cycle ergometry and pulmonary function testing were performed at entry, and every 6 months thereafter over 5 years. Due to the presence of missing data, a mixed-effect model analysis was then used to estimate the longitudinal changes in various clinical parameters.

Results: Peak oxygen uptake (V̇o2), peak minute ventilation (V̇e), and peak tidal volume (Vt) during exercise declined significantly over time (p < 0.0001), which was no less rapid than the deterioration in FEV1. The mean decline rates for peak V̇o2 were 32 ± 60 mL/min/yr and 0.5 ± 1.0 mL/min/kg/yr. Multiple regression analysis revealed that the changes in peak V̇e, peak Vt, and peak respiratory rates were significant predictors for the change in peak V̇o2.

Conclusion: We demonstrated clear evidence of measurable and progressive deterioration in exercise capacity in COPD patients, which was no less rapid than the decline in airflow limitation. Dynamic ventilatory constraints during exercise also deteriorated over time, which most significantly contributed to this exercise capacity deterioration. In addition to pulmonary function, the longitudinal follow-up of exercise capacity is important not to miss the overall deterioration in COPD.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543