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- Farkhooy, Amir, 1970-
(författare)
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Lung function in relation to exercise capacity in health and disease
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Exercise capacity (EC) is widely recognized as a strong and independent predictor of mortality and disease progression in various diseases, including cardiovascular and pulmonary diseases. Furthermore, it is generally accepted that exercise capacity in healthy individuals and in patients suffering from cardiovascular diseases is mainly limited by the maximum cardiac output.Objectives: This thesis investigated the impact of different lung function indices on EC in healthy individuals, patients with cardiovascular disease (e.g., pulmonary hypertension (PH)) and patients with pulmonary disease (e.g., chronic obstructive pulmonary disease (COPD)).Methods: The present thesis is based on cross-sectional and longitudinal analyses of patients suffering from COPD, attending pulmonary rehabilitation at Uppsala University Hospital (studies I and II), and healthy men enrolled in the “Oslo ischemia study” (study IV). Study III is a cross-sectional study of patients suffering from PH attending the San Giovanni Battista University Hospital in Turin. EC was assessed using a bicycle ergometer in studies I and IV, with 12-minute walk tests (12MWT) in study II and with 6-minute walk tests (6MWT) in study III. Extensive pulmonary function tests, including diffusing capacity of the lung (DLCO), were performed in studies I-III and dynamic spirometry was used to assess lung function in study IV.Results: DLCO is more closely linked to decreased levels of EC than airway obstruction in COPD patients. Furthermore, the decline in 12MWT over a 5-year period was mainly explained by deterioration in DLCO in COPD patients. Spirometric parameters indicating airway obstruction significantly related to EC and exercise-induced desaturation in PH patients. A significant, but weak association between lung function parameters and EC was found in healthy subjects and this association is strengthened with increasing age.Conclusion: DLCO is the strongest predictor of low EC and EC decline in COPD. In PH, airway obstruction is strongly related to reduced 6MWT. Therefore, extensive analysis of lung function, including measurements of diffusing capacity, along with standard assessment of airway obstruction, gives a more comprehensive assessment of the functional exercise capacity in patients suffering from pulmonary hypertension or COPD. Lung function is also significantly linked to EC even in healthy subjects, lacking evident cardiopulmonary diseases.
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- Kavianipour, Mohammad, et al.
(författare)
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Role of Echocardiography in the Diagnosis of Heart Failure with Preserved Left Ventricular Systolic Function : Uppdate 2013
- 2013
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Ingår i: Current Cardiovascular Imaging Reports. - New York : Springer Science and Business Media LLC. - 1941-9074 .- 1941-9066. ; 6:6, s. 523-533
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Tidskriftsartikel (refereegranskat)abstract
- Heart failure and its complications are significantcauses of mortality and morbidity in most societies. Majorparts of the studies that constitute the base of modern treatmentof heart failure have been limited to the study of heartfailure associated with reduced left ventricular ejection fraction(HFrEF). Only during the past 10–15 years, heart failureassociated with preserved left ventricular ejection fraction(HFpEF) or primarily right-sided heart failure have comemore into focus as our understanding of the critical role ofother etiologies for the clinical syndrome of heart failure thana reduced left ventricular (LV) ejection fraction has increased.Furthermore, whilst the powerful prognostic role of a reducedLV ejection fraction has long since been well validated, onlyrelatively recently it was realized that patients with heartfailure symptoms and preserved LVejection fraction also havea substantially impaired prognosis. Previously, these patientshad often been dismissed as not having "real heart failure". Inparallel, it has become clear that diagnoses like hypertensiveheart disease, diabetic cardiomyopathy and heart failure associatedwith atrial fibrillation, among others, can be understood as forms of HFpEF.
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