Statins for the Treatment of Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease

Background: Patients with chronic obstructive pulmonary disease (COPD) are at risk for pulmonary hypertension (PH). The aim of our study was to investigate the benefit of statins for PH in patients with COPD.Methods: The study enrolled 23 million individuals from Taiwan’s population database from January 1, 2002, to December 31, 2017. COPD patients who met the inclusion criteria were enrolled, and patients with lung cancer, less than one year of observation, specific drug therapy for PH and lung transplantation were excluded.Results: A total of 643,131 COPD patients were included in the study, and only 12,308 patients developed PH during follow-up. Based on the inclusion and exclusion criteria, 8,577 PH patients were included in the cohort of patients with PH related to COPD for analysis. According to the definition of statin exposure, the final study population had 1,487 statin users and 7,090 statin non-users. The statin user group had a lower mortality related to PH than the non-user group (3.87 vs. 5.55 per 100 person-years, p < 0.001). The mortality rate for PH in the multivariate analysis (aHR = 0.78, 95% CI = 0.62–0.98, p = 0.046) was significantly lower for statin users than for non-users.Conclusion: Statins seem to benefit patients with PH and COPD.

Download Full-text

Association between statin use and osteoporotic fracture in patients with chronic obstructive pulmonary disease: a population-based, matched case-control study

Lipids in Health and Disease ◽

10.1186/s12944-020-01412-6 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Hung-Yi Chen ◽

Pei-Yu Su ◽

Tsung-Kun Lin ◽

Gwo-Ping Jong

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Osteoporotic Fracture ◽

Statin Treatment ◽

Control Group ◽

Chronic Obstructive ◽

Statin User ◽

User Group ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Abstract Background In the recent years, chronic obstructive pulmonary disease (COPD) has been found to be associated with a higher risk of new-onset osteoporotic fracture (NOF). However, the existence of such an association in the COPD patients receiving statin treatment remains unknown. The present study aimed to investigate the association between COPD and NOF in statin-treated patients. Methods The present study was conducted over a period of 10 years (January 2004 to December 2013) in Taiwan. COPD patients receiving statin treatment were included in the statin user group, whereas the randomly selected statin non-users, with 1:1 matching for sex, age, index date, and Charlson Comorbidity Index, were included in the statin non-user group. The hazard ratio (HR) of NOFs in COPD patients was estimated between statin user and non-user groups. Results A total of 86,188 cases were identified as the statin-treated patients, and 86,188 subjects were included in the control group of statin non-users. Initially, the risk of NOF was found to be higher among the statin users as compared to non-users [HR, 1.12; 95% confidence interval (CI), 1.01–1.25]. However, the calculation of risk for NOFs after the adjustment for age, sex, comorbidities, and concurrent medications indicated no association of NOF (HR, 0.81; 95% CI, 0.55–1.21) with COPD in patients receiving statin treatment as compared to statin non-users. Conclusion The results of the study provided first evidence for the absence of any association between COPD and NOFs in statin-treated patients during a follow-up period of 10 years. Thus, the findings of this study might support the hypothesis stating the potent pleiotropic effects of statins. In clinical practice, these drugs might prove beneficial for the patients with COPD.

Download Full-text

Echocardiographic right heart study in patients with chronic obstructive pulmonary disease

Nepalese Heart Journal ◽

10.3126/njh.v14i2.18496 ◽

2017 ◽

Vol 14 (2) ◽

pp. 9-12

Author(s):

Anish Hirachan ◽

Arun Maskey ◽

Ram Kishore Shah ◽

Bishal KC ◽

Miqdhaadh Shareef ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Disease ◽

Heart Function ◽

Chronic Obstructive ◽

Rapid Progression ◽

Right Heart ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Right

Background and Aims: Chronic obstructive pulmonary disease (COPD) is highly prevalent in the Nepalese population. It is associated with significant extrapulmonary effects among which cardiovascular complications are most common. Echocardiography evaluation mainly focused on effects on the right heart function is a salient tool to evaluate the presence of degree of pulmonary hypertension and also identify those group of patients who need more early aggressive therapy for the underling lung disease . We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart.Methods: An observational, cross sectional study was done on 50 patients with COPD who were admitted at Bir Hospital and underwent echocardiographic evaluation from Dec 2015 –Dec 2016. All echocardiogaphic parameters focused on right heart and its function were assessed .Results: Out of total 50 COPD patients studied, majority of them were female (32 patients. 64%). The mean age group of the studied patients was 60.9 ±11.4 years. Pulmonary hypertension defined as sPAP>30 mmHg was evident in all of the patients ; with 30 patients (60% ), 14 (28 %) and 6(12 %) patients having severe, moderate and mild pulmonary hypertension respectively. RV dysfunction was evident with reduced average TAPSE values (1.59± 0.38 cm) and elevated RIMP values (0.58±0.16).Conclusion: Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness.Nepalese Heart Journal 2017; Vol 14(2), 9-12

Download Full-text

Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: echocardiography changes and their relation to the level of airflow limitation

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.848 ◽

2019 ◽

Vol 7 (21) ◽

pp. 3568-3573

Author(s):

Daniela Buklioska Ilievska ◽

Jordan Minov ◽

Nade Kochovska Kamchevska ◽

Biljana Prgova Veljanova ◽

Natasha Petkovikj ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Disease ◽

Doppler Echocardiography ◽

Mean Value ◽

Airflow Limitation ◽

Left Ventricular Ejection ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Objective. To compare frequency of echocardiographic changes in patients with chronic obstructive pulmonary disease (COPD) and non-COPD controls and to assess their relation to the level of airflow limitation. Methods. Study population included 120 subjects divided in two groups. Group 1 included 60 patients with COPD (52 male and 8 female, aged 40 to 80 years) initially diagnosed according to the actual recommendations. Group 2 included 60 subjects in whom COPD was excluded serving as a control. The study protocol consisted of completion of a questionnaire , pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray) and two dimensional (2D) Doppler echocardiography. Results. We found significantly higher mean right ventricle end-diastolic dimension (RVEDd) in COPD patients as compared to its dimension in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000). Pulmonary hypertension (PH) was more frequent in COPD patients than in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000) showing linear relationship with severity of airflow limitation. The mean value of left ventricular ejection fraction (LVEF%) was significantly lower in COPD patients than its mean value in controls (57.4 ± 6.9% vs. 64.8 ± 2.7; P = 0.0000) with no correlation with severity of airflow limitation. Conclusion. Frequency of echocardiographic changes in COPD patients was significantly higher as compared to their frequency in controls in the most cases being significantly associated with severity of airflow limitation. Echocardiography enables early, noninvasive, and accurate diagnosis of cardiac changes in COPD patients giving time for early intervention. Key words: airflow limitation, chronic obstructive pulmonary disease, Doppler echocardiography, pulmonary hypertension, ventricular dysfunction.

Download Full-text

Echocardiographic Evaluation of Cardiac Status in Patients with Chronic Obstructive Pulmonary Disease

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v46i3.52256 ◽

2021 ◽

Vol 46 (3) ◽

pp. 204-210

Author(s):

Muhammad Mohiuddin ◽

Abdul Wadud Chowdhury ◽

Kazi Nazrul Islam ◽

Mohammad Gaffar Amin ◽

Abu Thaher Mohammad Mahfuzul Hoque ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Diastolic Dysfunction ◽

Pulmonary Disease ◽

Systolic Dysfunction ◽

Respiratory Medicine ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Lv Diastolic Dysfunction

Background: Chronic Obstructive Pulmonary Disease (COPD) is a global health burden having systemic and extrapulmonary manifestations. Among them cardiovascular changes are the major comorbidity associated with COPD, responsible for significant morbidity and mortality. Echocardiography is one of the simplest and noninvasive tools in assessing these changes. Objective: To evaluate the echocardiographic changes in patients with chronic obstruction palmonary disease. Methods: A cross sectional observational study was carried out in Department of Cardiology and Department of Respiratory Medicine, Dhaka Medical College Hospital from July, 2018 to June, 2019. Total 98 COPD patients were included in the study. They underwent spirometry in Department of Respiratory Medicine and echocardiography in Department of Cardiology. Data was collected from the patients and recorded in a structured report form. Results: Significant echocardiographic abnormalities were present in 51.02% patients. Most common echocardiographic change was pulmonary hypertension (43.9%). Other echocardiographic findings were dilated RA & RV (36.7%), RVH (35.7%), LV diastolic dysfunction (30.6%) and RV systolic dysfunction (9.2%). Echocardiographic signs of pulmonary hypertension, dilated RA & RV, RVH, RV systolic dysfunction and LV diastolic dysfunction were correlated with the severity of the disease. Though echocardiographic change of pulmonary hypertension was uncommon in COPD stage 1 & 2, but it was very common in stage 3(45.7%) & stage 4(92.9%). Conclusion: This study showed that echocardiographic changes were very common among the COPD GOLD stage 3 & 4 patients. Though these changes were infrequent among mild COPD patients but their severity increased with increasing stage of COPD. Bangladesh Med Res Counc Bull 2020; 46(3): 204-210

Download Full-text

Diffusing capacity in chronic obstructive pulmonary disease assessment: A meta-analysis

Chronic Respiratory Disease ◽

10.1177/14799731211056340 ◽

2021 ◽

Vol 18 ◽

pp. 147997312110563

Author(s):

Yingmeng Ni ◽

Youchao Yu ◽

Ranran Dai ◽

Guochao Shi

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Carbon Monoxide ◽

Pulmonary Hypertension ◽

Pulmonary Disease ◽

Meta Analysis ◽

Chronic Obstructive ◽

Diffusing Capacity ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Exacerbation Risk

To achieve a multidimensional evaluation of chronic obstructive pulmonary disease (COPD) patients, the spirometry measures are supplemented by assessment of symptoms, risk of exacerbations, and CT imaging. However, the measurement of diffusing capacity of the lung for carbon monoxide (DLCO) is not included in most common used models of COPD assessment. Here, we conducted a meta-analysis to evaluate the role of DLCO in COPD assessment. The studies were identified by searching the terms “diffusing capacity” OR “diffusing capacity for carbon monoxide” or “DLCO” AND “COPD” AND “assessment” in Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Scopus, and Web of Science databases. The mean difference of DLCO % predict was assessed in COPD patient with different severity (according to GOLD stage and GOLD group), between COPD patients with or without with frequent exacerbation, between survivors and non-survivors, between emphysema dominant and non-emphysema dominant COPD patients, and between COPD patients with or without pulmonary hypertension. 43 studies were included in the meta-analysis. DLCO % predicted was significantly lower in COPD patients with more severe airflow limitation (stage II/IV), more symptoms (group B/D), and high exacerbation risk (group C/D). Lower DLCO % predicted was also found in exacerbation patients and non-survivors. Low DLCO % predicted was related to emphysema dominant phenotype, and COPD patients with PH. The current meta-analysis suggested that DLCO % predicted might be an important measurement for COPD patients in terms of severity, exacerbation risk, mortality, emphysema domination, and presence of pulmonary hypertension. As diffusion capacity reflects pulmonary ventilation and perfusion at the same time, the predictive value of DLCO or DLCO combined with other criteria worth further exploration.

Download Full-text

Increased pulmonary serotonin transporter in patients with chronic obstructive pulmonary disease who developed pulmonary hypertension

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-020-05056-7 ◽

2020 ◽

Author(s):

Armin Frille ◽

Michael Rullmann ◽

Georg-Alexander Becker ◽

Marianne Patt ◽

Julia Luthardt ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Disease ◽

Serotonin Transporter ◽

Lung Tissue ◽

Chronic Obstructive ◽

Right Heart ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Pet Ct

Abstract Purpose Pulmonary hypertension (PH) is characterized by a progressive remodelling of the pulmonary vasculature resulting in right heart failure and eventually death. The serotonin transporter (SERT) may be involved in the pathogenesis of PH in patients with chronic-obstructive pulmonary disease (COPD). This study investigated for the first time the SERT in vivo availability in the lungs of patients with COPD and PH (COPD+PH). Methods SERT availability was assessed using SERT-selective [11C]DASB and positron emission tomography/computed tomography (PET/CT) with dynamic acquisition over 30 min in 4 groups of 5 participants each: COPD, COPD+PH, pulmonary arterial hypertension, and a healthy control (HC). Time activity curves were generated based on a volume of interest within the middle lobe. Tissue-to-blood concentration ratios after 25 to 30 min (TTBR25–30) served as receptor parameter for group comparison and were corrected for lung tissue attenuation. Participants underwent comprehensive pulmonary workup. Statistical analysis included group comparisons and correlation analysis. Results [11C]DASB uptake peak values did not differ among the cohorts after adjusting for lung tissue attenuation, suggesting equal radiotracer delivery. Both the COPD and COPD+PH cohort showed significantly lower TTBR25–30 values after correction for lung attenuation than HC. Attenuation corrected TTBR25–30 values were significantly higher in the COPD+PH cohort than those in the COPD cohort and higher in non-smokers than in smokers. They positively correlated with invasively measured severity of PH and inversely with airflow limitation and emphysema. Considering all COPD patients ± PH, they positively correlated with right heart strain (NT-proBNP). Conclusion By applying [11C]DASB and PET/CT, semiquantitative measures of SERT availability are demonstrated in the lung vasculature of patients with COPD and/or PH. COPD patients who developed PH show increased pulmonary [11C]DASB uptake compared to COPD patients without PH indicating an implication of pulmonary SERT in the development of PH in COPD patients.

Download Full-text

Diagnostic importance of natriuretic peptide in chronic obstructive pulmonary disease with chronic hypoxemic respiratory failure

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-4-174-179 ◽

2020 ◽

Vol 4 (4) ◽

pp. 174-179

Author(s):

N.A. Kuzubova ◽

◽

O.N. Titova ◽

V.A. Volchkov ◽

D.B. Sklyarova ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Respiratory Failure ◽

Pulmonary Disease ◽

Natriuretic Peptide ◽

Chronic Obstructive ◽

Hypoxemic Respiratory Failure ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Diagnostic Importance

Background: the progression of chronic obstructive pulmonary disease (COPD) is accompanied by pulmonary hypertension and right ventricular failure as well as left ventricular failure that can be associated with the elevated levels of N-terminal pro b-type natriuretic peptide (NT-proBNP). Aim: to evaluate the diagnostic importance of NT-proBNP in COPD with chronic hypoxemic respiratory failure. Patients and Methods: 60 patients with COPD GOLD stage 3 and 4 (group D, mixed phenotype: emphysematous bronchitic) during remission were examined. Mean age was 64.78±6.9 years. The patients were divided into three groups. Group 1 included 20 COPD patients with hypoxemia who received long-term oxygen therapy (LTOT). Group 2 included 20 COPD patients with hypoxemia who did not receive LTOT. Group 3 included 20 COPD patients with normoxemia. After the primary examination, group 1 patients were prescribed with in-home LTOT (16 hours daily). Group 2 and 3 patients were not prescribed with LTOT. All patients received basic treatment, i.e., a combined drug containing an inhaled corticosteroid and β2-agonist (budesonide/formoterol 400/12 μg twice daily) and a long-acting muscarinic antagonist (tiotropium bromide 2.5 μg, 2 inhalations once daily). The patients were reexamined after 12 months. Arterial blood gases and serum NT-proBNP concentration were measured, spirometry and Doppler echocardiography were performed. Results: NT-proBNP levels in COPD patients with hypoxemia were significantly elevated. The associations between NT-proBNP and partial oxygen arterial pressure (r= -0.71, p<0.05), NT-proBNP and pulmonary artery systolic pressure (PASP) (r=0.61, p<0.05) were revealed. ROC analysis of NT-proBNP demonstrated its sensitivity and specificity in COPD patients with the different severity of respiratory failure. LTOT for COPD with hypoxemia reduces PASP, improves left ventricular diastolic function, and decreases NT-proBNP levels. Conclusions: as chronic hypoxemic respiratory failure progresses in COPD, NT-proBNP concentration increases. ROC analysis demonstrates that NT-proBNP can be considered as a promising marker of hypoxemia and pulmonary hypertension. LTOT reduces NT-proBNP levels by improving pulmonary cardiac hemodynamics. KEYWORDS: COPD, hypoxemia, natriuretic peptide, long-term oxygen therapy, pulmonary hypertension, diastolic dysfunction, right ventricle. FOR CITATION: Kuzubova N.A., Titova O.N., Volchkov V.A., Sklyarova D.B. Diagnostic importance of natriuretic peptide in chronic obstructive pulmonary disease with chronic hypoxemic respiratory failure. Russian Medical Inquiry. 2020;4(4):174–179. DOI: 10.32364/2587-6821- 2020-4-4-174-179.

Download Full-text

Prevalence of pulmonary hypertension in COPD

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20181061 ◽

2018 ◽

Vol 5 (2) ◽

pp. 356

Author(s):

Vivek Katiyar ◽

Rajesh Kumar Khare

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Disease ◽

Study Finding ◽

Chronic Obstructive ◽

Medical Sciences ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Chest X Ray ◽

Underlying Diseases

Background: Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality in adults all over the world. Pulmonary hypertension (PH) is a severe disorder defined by a mean pulmonary artery pressure of ≥25 mmHg at rest. Pulmonary hypertension can occur as an isolated disease or as a consequence of a number of underlying diseases and conditions, such as heart failure and chronic obstructive pulmonary disease (COPD). The aim of our study was to study the prevalence of pulmonary hypertension in COPD patients and to highlight the importance of early diagnosis of pulmonary hypertension to prevent further complications.Methods: This was a retrospective observational hospital based study conducted at Integral Institute of Medical Sciences and Research Lucknow U P, during 1st January to 31st December 2017. A total of 210 patients were evaluated for presence of pulmonary hypertension using chest X-ray, electrocardiogram, 2D echocardiography.Results: The present study finding reveals 38.02 % patients of various severity of COPD have findings of pulmonary hypertension, that is similar in prevalence of previous studies.Conclusions: The prevalence of PH in patients with COPD was 38.02%. As PH has an important role in the prognosis of COPD patients, it should be evaluated in as many COPD patients as possible.

Download Full-text

Echocardiographic Right Heart Study in Patients with Chronic Obstructive Pulmonary Disease

Medicine Today ◽

10.3329/medtoday.v33i2.56057 ◽

2021 ◽

Vol 33 (2) ◽

pp. 123-128

Author(s):

Kazi Shamim Al Mamun ◽

Mohammad Ibrahim Chowdhury ◽

Muhammad Khurshed Alam ◽

Syedul Alam Khuryshi ◽

SM Ifteakharul Islam

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Hypertension ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Rapid Progression ◽

Right Heart ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

The Right

Introduction: Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes. Aims: We aimed to prospectively study the patients with diagnosed COPD with echocardiogram for evaluating the right heart. Materials & Methods: Our study was an observational, cross sectional study was done on 50 patients with COPD who were admitted at Department of Cardiology, CMCH and underwent echocardiographic evaluation from November 2017 –October 2018. All echocardiogaphic parameters focused on right heart and its function were assessed. Results: Out of total 50 COPD patients studied, majority of them were male (46 patients ,92%). The mean age group of the studied patients was 58.4 ±7.7 years. Pulmonary hypertension defined as sPAP>30 mmHg was evident in all of the patients; with 30 patients (60%), 14 (28 %) and 6(12 %) patients having severe, moderate and mild pulmonary hypertension respectively. RV dysfunction was evident with reduced average TAPSE values (1.59± 0.38 cm) and elevated RIMP values (0.58±0.16). Conclusion: Majority of COPD patients had evidence of pulmonary hypertension. Echocardiogram can be a helpful tool to assess early changes on the right heart size and function in patients with COPD and also monitor these patients for rapid progression of the illness. Medicine Today 2021 Vol.33(2): 123-128

Download Full-text

Perspiration During Exercise in Patients With Stable Chronic Obstructive Pulmonary Disease

10.21203/rs.3.rs-49970/v1 ◽

2020 ◽

Author(s):

Zheng Li ◽

Yanxin Zhang ◽

Jing Wang ◽

Dan Xu ◽

Jing Jing ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Logistic Regression ◽

Pulmonary Disease ◽

Cardiopulmonary Exercise Testing ◽

Chronic Obstructive ◽

Excessive Sweating ◽

Obstructive Pulmonary Disease ◽

Copd Exacerbations ◽

Copd Patients ◽

One Year

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a common progressive respiratory condition. Chills in the back region with excessive sweating are common symptoms in COPD patients. The aim of our study was to identify factors associated with increased rates of perspiration in COPD patients.Methods: We performed a prospective cohort study over the course of one year by recruiting 120 COPD patients and 32 healthy controls. All patients underwent pulmonary function testing (PFT) and cardiopulmonary exercise testing (CPET). The rate of perspiration was determined during CPET through sweat collection. The relationship between perspiration rate and multiple clinical and physiologic variables was explored through correlative analyses. Logistic regression analysis was used to reveal the multifactorial influence on the risk of acute COPD exacerbations.Results: Results showed that COPD patients were found to have a higher rate of perspiration during CPET than healthy individuals. We observed a direct relationship between perspiration rate and clinical measures of disease severity such as air flow limitations and the number of acute COPD exacerbations. The rate of perspiration was also found to be correlated with several clinical (i.e. number of hospitalizations) as well as physiologic variables (i.e. PFT and CPET parameters). Lastly, we generated a logistic regression model which predicted the likelihood of acute COPD exacerbations with an accuracy of 87.4%. Thus, elevated perspiration rates during exercise are observed in COPD patients, which is also directly correlated with the degree of dyspnea and disease progression.Conclusions: perspiration may be used as a biomarker for disease state with prognostic value.

Download Full-text