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Title: Determinants of exercise-induced oxygen desaturation including pulmonary emphysema in COPD: Results from the ECLIPSE study
Authors: Andrianopoulos, Vasileios
Celli, Bartolome R.
Franssen, Frits M. E.
Pinto-Plata, Victor M.
Calverley, Peter M. A.
Vanfleteren, Lowie E. G. W.
Vogiatzis, Ioannis
Vestbo, Jorgen
Agusti, Alvar
Bakke, Per S.
Rennard, Stephen I.
MacNee, William
Tal-Singer, Ruth
Yates, Julie C.
Wouters, Emiel F. M.
SPRUIT, Martijn A. 
Issue Date: 2016
Source: RESPIRATORY MEDICINE, 119, p. 87-95
Abstract: Exercise-induced oxygen desaturation (EID) is related to mortality in patients with chronic obstructive pulmonary disease (COPD). We investigated: (1) the prevalence of EID; (2) the relative-weight of several physiological determinants of EID including pulmonary emphysema, and (3) the relationship of EID with certain patients' clinical characteristics. Data from 2050 COPD patients (age: 63.3 +/- 7.1years; FEV1: 48.7 +/- 15.7%pred.) were analyzed. The occurrence of EID (SpO(2)post <= 88%) at the six-minute walking test (6MWT) was investigated in association with emphysema quantified by computed-tomography (QCT), and several clinical characteristics. 435 patients (21%) exhibited EID. Subjects with EID had more QCT-emphysema, lower exercise capacity and worse health-status (BODE, ADO indexes) compared to non-EID. Determinant of EID were obesity (BMI >= 30 kg/m(2)), impaired FEV1 (<= 44%pred.), moderate or worse emphysema, and low SpO(2) at rest (<= 93%). Linear regression indicated that each 1-point increase on the ADO-score independently elevates odds ratio (<= 1.5fold) for EID. About one in five COPD patients in the ECLIPSE cohort present EID. Advanced emphysema is associated with EID. In addition, obesity, severe airflow limitation, and low resting oxygen saturation increase the risk for EID. Patients with EID in GOLD stage II have higher odds to have moderate or worse emphysema compared those with EID in GOLD stage Emphysematous patients with high ADO-score should be monitored for EID. (C) 2016 Elsevier Ltd. All rights reserved.
Notes: [Andrianopoulos, Vasileios; Franssen, Frits M. E.; Vanfleteren, Lowie E. G. W.; Wouters, Emiel F. M.; Spruit, Martijn A.] Ctr Expertise Chron Organ Failure, Dept Res & Educ, CIRO, Horn, Netherlands. [Andrianopoulos, Vasileios] Schoen Klin Berchtesgadener Land, Dept Resp Med & Pulm Rehabil, Schoenau, Germany. [Celli, Bartolome R.] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA. [Pinto-Plata, Victor M.] Univ Liverpool, Sch Clin Sci, Dept Resp Med, Liverpool L69 3BX, Merseyside, England. [Calverley, Peter M. A.] Aintree Univ Hosp NHS Fdn Trust, Inst Ageing & Chron Dis, Liverpool, Merseyside, England. [Vanfleteren, Lowie E. G. W.; Wouters, Emiel F. M.] Maastricht Univ, Med Ctr MUMC, Dept Resp Med, Maastricht, Netherlands. [Vogiatzis, Ioannis] Univ Athens, Dept Phys Educ & Sport Sci, Athens, Greece. [Vestbo, Jorgen] Univ Manchester, Ctr Resp Med & Allergy, Manchester M13 9PL, Lancs, England. [Agusti, Alvar] Univ Barcelona, Resp Inst, Hosp Clin, IDIBAPS,CIBERES, Barcelona, Spain. [Bakke, Per S.] Univ Bergen, Dept Clin Sci, Bergen, Norway. [Rennard, Stephen I.] Univ Nebraska Med Ctr, Pulm & Crit Care Med, Omaha, NE USA. [MacNee, William] Univ Edinburgh, Queens Med Res Inst, Ctr Inflammat Res, MRC, Edinburgh, Midlothian, Scotland. [Tal-Singer, Ruth] GSK Res & Dev, Philadelphia, PA USA. [Yates, Julie C.] GSK, Res Triangle Pk, NC USA. [Spruit, Martijn A.] Hasselt Univ, Fac Med & Life Sci, REGAL Rehabil Res Ctr, BIOMED Biomed Res Inst, Diepenbeek, Belgium.
Keywords: 6MWD; EID; ADO index; Emphysema; Computed tomography; Imaging;6MWD; EID; ADO index; Emphysema; Computed tomography; Imaging
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ISSN: 0954-6111
e-ISSN: 1532-3064
DOI: 10.1016/j.rmed.2016.08.023
ISI #: 000385321200015
Rights: © 2016 Elsevier Ltd. All rights reserved.
Category: A1
Type: Journal Contribution
Validations: ecoom 2017
Appears in Collections:Research publications

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