scholarly journals Maximal Voluntary Breath-Holding Tele-Inspiratory Test in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 15 (3) ◽  
pp. 155798832110158
Author(s):  
Abir Hedhli ◽  
Azza Slim ◽  
Yassine Ouahchi ◽  
Meriem Mjid ◽  
Jamel Koumenji ◽  
...  

Maximal voluntary inspiratory breath-holding time (MVIBHT) has proved to be of clinical utility in some obstructive ventilatory defects. This study aims to correlate the breath-holding time with pulmonary function tests in patients with chronic obstructive pulmonary disease (COPD) and to determine the feasibility of using a breath-holding test in assessing the severity of COPD. A cross-sectional study including male patients with stable COPD were conducted. Patients with respiratory comorbidities and severe or unstable cardiac diseases were excluded. Patients were interviewed and examined. Six-minute walk test (6MWT) and plethysmography were performed.For MVIBHT collection, the subject was asked to inspire deeply and to hold the breath as long as possible at the maximum inspiratory level. This maneuver was repeated three times. The best value was used for further analysis. A total of 79 patients (mean age: 64.2 ± 8) were included in this study. The mean value of MVIBHT was 24.2 ± 8.5 s. We identified a positive and significant correlations between MVIBHT and forced vital capacity ( r = .630; p < .001) as well as MVIBHT and forced expiratory volume in 1 s (FEV1%) ( r = .671; p < .001). A significant inverse correlation with total lung capacity ( r = −.328; p = .019) and residual volume to total lung capacity ratio ( r = −.607; p < .001) was noted. MVIBHT was significantly correlated to the distance in the 6MWT ( r = .494; p < .001). The mean MVIBHT was significantly different within spirometric grades ( p < .001) and GOLD groups ( p = .002). At 20.5 s, MVIBHT had a sensitivity of 72% and specificity of 96% in determining COPD patients with FEV1 <50%. Our results provide additional evidence of the usefulness of MVIBHT in COPD patients as a pulmonary function parameter.

2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Jin Hwa Lee ◽  
Merry-Lynn N McDonald ◽  
Michael H Cho ◽  
Emily S Wan ◽  
Peter J Castaldi ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249786
Author(s):  
Anouk A. F. Stoffels ◽  
Bram van den Borst ◽  
Jeannette B. Peters ◽  
Mariska P. M. Klaassen ◽  
Hanneke A. C. van Helvoort ◽  
...  

Background The endurance shuttle walk test (ESWT) is used to evaluate exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). The recommended pre-intervention tolerated duration (Tlim) is between 3–8 minutes for optimal interpretation of treatment effects. However, this window may be exceeded and factors determining ESWT Tlim are not completely understood. Therefore, we aimed to determine whether pulmonary function, physical and incremental shuttle walk test (ISWT) performance measures are associated with ESWT Tlim in COPD patients. Methods Assessment data from patients eligible for pulmonary rehabilitation was retrospectively analyzed. Inclusion criteria were: diagnosis of COPD and complete data availability regarding ESWT and ISWT. Patients performed an ESWT at 85% of ISWT speed and were divided into three groups (ESWT Tlim: <3 minutes, 3–8 minutes, >8 minutes). Subject characteristics, severity of complaints, pulmonary function, physical capacity and activity, exercise tolerance and quadriceps muscle strength were evaluated. Results 245 COPD patients (FEV1 38 (29–52)% predicted) were included. Median ESWT Tlim was 6.0 (3.7–10.3) minutes, 41 (17%) patients walked <3 minutes and 80 (33%) patients walked >8 minutes. Body mass index, maximal oxygen consumption, Tlim on constant work rate cycle test, physical activity level, maximal ISWT speed, dyspnoea Borg score at rest and increase of leg fatigue Borg score during ISWT independently predicted Tlim in multivariate regression analysis (R2 = 0.297, p<0.001). Conclusion This study reported a large variability in ESWT Tlim in COPD patients. Secondly, these results demonstrated that next to maximal ISWT speed, other ISWT performance measures as well as clinical measures of pulmonary function, physical capacity and physical activity were independent determinants of ESWT Tlim. Nevertheless, as these determinants only explained ~30% of the variability, future studies are needed to establish whether additional factors can be used to better adjust individual ESWT pace in order to reduce ESWT Tlim variability.


2018 ◽  
Vol 25 (15) ◽  
pp. 1667-1674 ◽  
Author(s):  
Ernesto Crisafulli ◽  
Matteo Vigna ◽  
Antonella Ielpo ◽  
Panagiota Tzani ◽  
Angelo Mangia ◽  
...  

Background Heart rate recovery delay is a marker of cardiac autonomic dysfunction. In chronic obstructive pulmonary disease patients, the ventilatory response to exercise during incremental cardiopulmonary exercise test may add information about dynamic hyperinflation by low values of inspiratory capacity/total lung capacity ratio (at peak) and excess ventilation by the slope of minute ventilation to carbon dioxide output ratio (VE/VCO2 slope). We aimed to assess if the ventilatory response to exercise might be a determinant for heart rate recovery delay. Design An observational, prospective study. Methods Anthropometric characteristics, lung function and cardiopulmonary exercise test data were recorded in chronic obstructive pulmonary disease outpatients. A cut-off of heart rate recovery of 12 or more beats was used to define heart rate recovery delay. Results Of 254 patients enrolled, 156 (61%) showed heart rate recovery delay. As compared to patients with normal heart rate recovery, patients with delay were older, with a worse lung function and with lower values of peak oxygen uptake, maximal workload, oxygen pulse at rest and at peak, and inspiratory capacity/total lung capacity at peak. Conversely, VE/VCO2 slope and dyspnoea and leg fatigue perception at peak were higher in patients with heart rate recovery delay. In the multivariate regression model adjusted for age, sex, fat-free mass, heart rate at rest and use of β-blockers, we found that inspiratory capacity/total lung capacity at peak (<0.25) (odds ratio 2.61; P = 0.007) and VE/VCO2 slope (>32) (odds ratio 2.26; P = 0.018) predict the risk of heart rate recovery delay. Conclusions In chronic obstructive pulmonary disease outpatients, heart rate recovery is associated with dynamic hyperinflation and excess ventilation during exercise.


2013 ◽  
Vol 3 (2) ◽  
pp. 42-45 ◽  
Author(s):  
K Begum ◽  
MK Begum ◽  
ZH Sarker ◽  
MRK Dewan ◽  
MJH Siddique

The aim of this study was to evaluate the serum level of total cholesterol, triglycerides (TG), low density lipoproteins (LDL) and high density lipoproteins, (HDL) in chronic obstructive pulmonary disease (COPD) patients admitted in National Institute of Disease of Chest and Hospital, Mohakhali, Dhaka during. January 2009 to January 2010. Twenty two patients with COPD and 22 healthy controls were included in this study. Total cholesterol, HDL and TG levels were determined with ILAB 1800 Chemistry Analyzer using ILAB test Reagents. LDL concentration was calculated using the Friedewald Equation. The mean level of TG was 150.04±29.66 mg/dl and 126.14±13.28 in COPD patients and healthy control, respectively. A statistically significant difference was found between the two groups (p<0.001). The mean level of TC was 181.83±20.11 mg/dl and 176.28±15.35 mg/dl in COPD patients and healthy control respectively (p<0.001). LDL level mean value was 116.12±14.26 mg/dl and 108.95±10.39 in COPD patients and control respectively (p<0.001). The mean value of HDL showed 38.79±2.4 in COPD patients and 39.014±1.56 in control. A statistically significance was also found between the two groups (p<0.001). Our results showed that the values of TC, TG, LDL were higher than healthy control that is highly significant statistically. On the other hand, the was significantly decreased HDL level compared with controls. DOI: http://dx.doi.org/10.3329/bjmb.v3i2.13810 Bangladesh J Med Biochem 2010; 3(2): 42-45


2021 ◽  
Author(s):  
Sang Won Park ◽  
Myoung-Nam Lim ◽  
Woo Jin Kim ◽  
So Hyeon Bak

Abstract BackgroundChest computed tomography(CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. However, there are few studies of changes in vascular during longitudinal follow-up in COPD patients. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.Materials and MethodsA total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856exp). Total number of vessels (Ntotal) and total number of vessels with area less than 5 mm2 (N<5mm) per 1 cm2 of lung surface area (LSA) were measured at 6 mm from the pleural surface.ResultsNtotal/LSA and N<5mm/LSA changed from 1.16±0.27 to 0.87±0.2 and from 1.02±0.22 to 0.78±0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39±0.21 to 0.74±0.17 and from 1.18±0.19 to 0.67±0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with Ntotal/LSA (r=-0.738, -0.529) and N<5mm /LSA (r=-0.729, -0.497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with Ntotal/LSA and N<5mm/LSA (r=0.205, 0.210). The depth in CT subtypes for longitudinal change both Ntotal/LSA and N<5mm/LSA was (-0.032, -0.023) and (-0.027) in normal and SAD, respectively.ConclusionsQuantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.Trial registrationWe obtained the written informed consent from all participants in this study and the approval for all processes by our institution Institutional Review Board.


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