Abstract: Poster Presentations |

Hemodynamic Changes to Exercise in Patients with COPD and Normal Controls FREE TO VIEW

B. R. Celli, MD; Giri Hoskere, MD*; Jay B. Mehta, MD; Michael Ponder, MD; Mirle R. Girish, MD
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Johnson City Medical Center, Johnson City, TN


Chest. 2004;126(4_MeetingAbstracts):922S-b-923S. doi:10.1378/chest.126.4_MeetingAbstracts.922S-b
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PURPOSE:  To assess the hemodynamic changes to exercise in patients with COPD and normal control using impedance cardiography (ICG).

METHODS:  We studied 10 COPD patients (FEV1 = 36% predicted) and 5 controls (FEV1 = 90% predicted). Hemodynamic monitoring was done non invasively before and after 6 minute walking test using impedance cardiography byBioZ ® ICG Monitor (Cardio dynamics Inc, San Diego, CA).

RESULTS:  The increase in cardiac out put and cardiac index post exercise was only 7% and 8% respectively in COPD patients as compared to normal (34%, p= 0.01). The systemic vascular resistance increased by 1% after exercise in COPD, whereas in normal controls it came down by 16 %. There was no difference in heart rate and blood pressure response.

CONCLUSION:  Ventilatory limitations and cardiac impairment seem to be the cause of limited exercise capacity in COPD. Possible explanations, such as dynamic hyperinflation with intra-thoracic pressures limiting cardiac contractility and stroke volume and/or decreased pulmonary vascular capacitance remain to be explored.

CLINICAL IMPLICATIONS:  Limitation of exercise capacity in COPD patients is thought to be due to a decreased ventilatory reserve. Based on our data, the role of the cardiovascular system may be more important in exercise limitation than previously thought. Pre ExerciseCOPDControlp ValuePost ExerciseCOPDControlp ValueCO5.365.42.29CO5.727.24.04*CI2.913.12.07CI3.154.18.01*SVR14991313.32SVR16691107.19HR8378.89HR93108.29VAS3.90.002*VAS7.43.8.001*MAP9793.47MAP111102.896M walk976 ft2167 ft.01*

DISCLOSURE:  G. Hoskere, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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