What is the impact of impaired left ventricular ejection fraction in COPD after adjusting for confounders?

Int J Cardiol. 2016 Dec 15:225:365-370. doi: 10.1016/j.ijcard.2016.10.016. Epub 2016 Oct 11.

Abstract

Background: It remains unknown whether and to what extent impaired left ventricular ejection fraction (LVEF) affects physical and psychological status in COPD. We aimed to compare health outcome measures between COPD patients with and without impaired LVEF after adjusting for age, sex, BMI and FEV1.

Methods: Impaired LVEF was defined as values <50%. 85 COPD patients with impaired LVEF and 85 COPD patients with normal LVEF were matched for sex, age, BMI and FEV1. Exercise capacity, quadriceps muscle function, functional mobility, inflammatory status, health status, care dependency, and mood disorders were cross-sectionally assessed.

Results: Patients with impaired LVEF had shorter 6-minute walk distance (mean -59 (95% confidence interval: -94, -25)m), lower symptom-limited peak oxygen uptake (-131 (-268, 7)ml/min), weaker quadriceps muscles (-12 (-20, -3)Nm) and had more symptoms of anxiety (+2 (1, 3) points) and depression (+1 (0, 2) points) than those with normal LVEF (all P<0.05). Health status was not statistically different between groups (P>0.05).

Conclusions: Impaired LVEF has a clear impact on physical and psychological status in patients with COPD, even after adjusting for confounders. This reinforces the importance of assessing and treating cardiac problems in COPD.

Keywords: Chronic heart failure; Chronic obstructive pulmonary disease; Comorbidity; Outcome assessment (health care).

MeSH terms

  • Absorptiometry, Photon / methods
  • Aged
  • Confounding Factors, Epidemiologic
  • Cross-Sectional Studies
  • Exercise Tolerance / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging*
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Stroke Volume / physiology*
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left / physiology*
  • Walk Test / methods