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- Farkhooy, Amir, et al.
(author)
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Lung function in relation to six-minute walk test in pulmonary hypertension
- 2020
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In: European Clinical Respiratory Journal. - : Informa UK Limited. - 2001-8525. ; 7:1
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Journal article (peer-reviewed)abstract
- Background: Pulmonary hypertension (PH) is a progressive disorder of the pulmonary circulation,associated with diverse medical conditions. Exercise limitation is the most prominent symptom inPH. Exercise capacity, commonly assessed through a six-minute walk test (6MWT), correlates withboth functional status and survival in PH. Few studies have analysed the relation betweenrespiratory function and exercise limitation. Therefore, we investigated the relationship betweenresting pulmonary function, exercise capacity, and exertional desaturation, assessed through the6MWT, in unselected PH patients.Methods: Fifty consecutive patients with PH diagnosis, referred for pulmonary function testing(lung volume, spirometry, and diffusing capacity for carbon monoxide (DLCO)) and 6MWT, wererecruited at Molinette University Hospital, Turin.Results: The majority of the patients (54%) had PH due to left heart disease. Airway obstruction(FEV1/VC-ratio < 0.7) was found in 46% of the patients and they performed significantly worse inthe 6MWT than unobstructed patients (307 m vs. 377 m). Patients with PH due to left heartdisease also performed significantly poorer 6MWT when airway obstruction was present (305 mvs. 389 m). Twenty-two patients (44%) presented exertional desaturation upon 6MWT. LowerDLCO divided by the alveolar volume (DLCO/VA), FEV1/VC-ratios and resting PaO2-values weresignificantly correlated with exertional desaturation after adjustments for age, sex, BMI, andsmoking habits. DLCO/VA was the main determinant of exertional desaturation in a stepwiseregression model.Conclusions: Spirometric parameters of airway obstruction were related to walk distance andexercise-induced desaturation in PH patients. This suggests a place for spirometry in clinicalmonitoring of PH patients.
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- Malinovschi, Andrei, et al.
(author)
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Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients
- 2014
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In: Respiratory Research. - : Springer Science and Business Media LLC. - 1465-9921 .- 1465-993X. ; 15, s. 131-
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Journal article (peer-reviewed)abstract
- Background: Acute exacerbations of COPD (AECOPD) are common and strongly influence disease severity and relative healthcare costs. Vitamin D deficiency is frequent among COPD patients and its contributory role in disease exacerbations is widely debated. Our aim was to assess the relationship of serum vitamin D levels with COPD severity and AECOPD. Methods: Serum vitamin D (25-hydroxyvitamin D) levels were measured in 97 COPD patients and related to lung function, comorbidities, FEV1 decline, AECOPD and hospital admission during the previous year. Results: Most patients (96%) had vitamin D deficiency, which was severe in 35 (36%). No significant relationship was found between vitamin D and FEV1 or annual FEV1 decline. No difference between patients with and without severe vitamin D deficiency was found in age, gender, BMI, smoking history, lung function, and comorbidities, apart from osteoporosis (60.9% in severe deficiency vs 22.7%, p = 0.001). In multiple logistic regression models, severe deficiency was independently associated with AECOPD [adjusted odds ratios (aOR) of 30.5 (95% CI 5.55, 168), p < 0.001] and hospitalization [aOR 3.83 (95% CI 1.29, 11.4), p = 0.02]. The odds ratio of being a frequent exacerbator if having severe vitamin D deficiency was 18.1 (95% CI 4.98, 65.8) (p < 0.001), while that of hospitalization was 4.57 (95% CI 1.83, 11.4) (p = 0.001). Conclusions: In COPD patients severe vitamin D deficiency was related to more frequent disease exacerbations and hospitalization during the year previous to the measurement of vitamin D. This association was independent of patients' characteristics and comorbidities.
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