Pulmonary Exercise Testing Predicts Prognosis in Patients with Chronic Obstructive Pulmonary Disease
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概要
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Objective In patients with chronic obstructive pulmonary disease (COPD), patient age and initial value of forced expiratory volume in 1 second (FEV1) have been considered the most accurate predictors of mortality among the parameters obtained from pulmonary exercise tests. However, few studies have examined the predictive variables of prognosis among exercise parameters in COPD. We therefore attempted to identify the best index for predicting long-term survival in patients with COPD among the cardiopulmonary variables obtained during exercise testing.Patients and Methods Fifty-eight patients with COPD (50 men and 8 women) without hypoxemia at rest or other serious complications performed resting pulmonary function tests followed by a symptom-limited ramp exercise test on a cycle ergometer with breath-by-breath gas analysis and arterial blood gas sampling.Results After 3,570±1,373 days follow-up (mean±SD), 21 died because of deaths by respiratory failure. The overall survival rates calculated by the Kaplan-Meier method were 92.9% and 75.8% at 5 years and 10 years, respectively. In univariate Cox hazards analysis, age, FEV1, VC, RV/TLC, V Emax, V O2max, V CO2max, PaO2max, PaCO2max, and PaO2 at rest were found to be significant prognostic indices of survival. However, multivariate analysis revealed only FEV1, PaO2max, and age as independent predictors of mortality. In severe COPD patients (FEV1 <50% predicted, n=35), PaO2max and age also correlated with prognosis, whereas FEV1 did not.Conclusion Pulmonary exercise testing is useful in predicting prognosis in patients with COPD.
- 社団法人 日本内科学会の論文
- 2005-01-01
著者
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Miyazato Itsuro
Department of Biofunctional Informatics, Graduate School of Health Care Sciences, Tokyo Medical and
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Yoshizawa Yasuyuki
Department of Integrated Pulmonology, Tokyo Medical and Dental University
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Miyasaka Nobuyuki
Department Of Medicine And Rheumatology Tokyo Medical And Dental University Graduate School
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Yoshizawa Yasuyuki
Department Of Geriatric And Pulmonary Medicine Graduate School Tokyo Medical And Dental University
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Yoshizawa Yasuyuki
Department Of Pulmonary Medicine Tokyo Medical And Dental University
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Tojo Naoko
The Department Of Laboratory Medicine Tokyo Medical And Dental University
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TOJO Naoko
Department of Clinical Laboratory Medicine, Tokyo Medical and Dental University
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ICHIOKA Masahiko
Metropolitan Toshima Hospital
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CHIDA Mamoru
Tokyo Kyosai Hospital
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Miyasaka Nobuyuki
Department Of Bioregulatory Medicine And Rheumatology Faculty Of Medicine Tokyo Medical And Dental U
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Ichioka Masahiko
The Second Department Of Internal Medicine Tokyo Medical And Dental University
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Miyazato Itsuro
School Of Allied Health Science Faculty Of Medicine Tokyo Medical And Dental University
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Miyazato Itsuro
Department Of Biofunctional Informatics Graduate School Of Health Care Sciences Tokyo Medical And De
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Chida Mamoru
Tokyo Med Dent Univ
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Miyasaka Nobuyuki
Department Of Bioregulatory Medicine And Rheumatology Tokyo Medical And Dental University
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