Introduction: Phenotypic characterization of COPD subjects may rely on clinical and physiological manifestations, imaging, assessment of patient-related outcomes (health related quality of life), COPD comorbidities, COPD exacerbations and systemic inflammation. The aim of the study was to evaluate and to analyze the health-related quality of life (HRQL) in COPD patients classified into different phenotypes.
Methods: 395 consecutive COPD patients were enrolled into the study. Spirometric data were analyzed (FEV1, FVC, FEV1/FVC). HRQL was assessed by the St. George Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT) and Clinical COPD Questionnaire (CCQ).
Results: The cohort consisted of 395 COPD patients with mean age 62.7 ± 9.4 years, 79 % were males. Patients were divided in 4 groups according to phenotypes: 44% of the patients were nonexacerbators, 35% frequent exacerbators with chronic bronchitis (CB), 12% frequent exacerbators without CB, and 8% were patients with asthma-COPD overlap syndrome (ACOS). There were statistically significant differences in HRQL and lung function between COPD phenotypes. Frequent exacerbators with chronic CB and without CB had the similar total SGRQ scores, CCQ scores and CAT, and these scores were worse in comparison with HRQL of non-exacerbators and patients with ACOS.
Conclusion: Frequent exacerbators with chronic CB and without CB have a more severe deterioration of the HRQL and worse lung function then non-exacerbators and patients with ACOS.
Pulmonary Rehabilitation (PR) is an effective
intervention in COPD however the value of PR in reducing cardiovascular risk in
COPD (measured by aortic pulse wave velocity, PWV) is unclear and there is no
existing systematic review.
Objectives To conduct a systematic review examining whether PR
results in alteration of CV risk in COPD (as measured by aPWV).
An electronic systematic search concordant with PRISMA
guidelines was conducted. The search was complete to the 27th of May 2017. Six
databases were examined: Embase, Medline, AMED, Web of Science, Cochrane
clinical trials, and CINAHL.
This study generated 767 initial matches, which were
filtered using inclusion/exclusion criteria. Three studies (201 COPD
participants) were included. Our analysis does not confirm that PR affects aPWV
but studies were heterogeneous.
There is currently insufficient information on the
effect of PR on reducing CV risk in COPD. Therefore controversy remains, with
the possibility that there might be some subjects who benefit and others who
might experience an increase in CV risk in response to PR. These results will
be of value to those interested in gaining a better understanding of the
benefits of PR on CV risk in COPD.