Assessment of the cardiorespiratory state in a six-minute walk test in patients with chronic obstructive pulmonary disease with normal body mass and overweight

Chronic obstructive pulmonary disease (COPD) and overweight/obesity are among the leading health problems worldwide.

The objective: to conduct a comparative analysis of exercise tolerance in patients with COPD with normal body mass and overweight during a six-minute walk test using an original device for cardiorespiratory analysis and a method for assessing cardiorespiratory status.

Subjects and methods. 192 COPD patients were enrolled in the study. Patients were divided into two groups - with normal body mass and overweight. To assess exercise tolerance, six-minute walk test was used simultaneously with the device we developed specifically for cardiorespiratory analysis. The distance covered within 6 min (6MWD) was compared with the proper indicator of 6MWD (i).

Results. In patients with normal body weight compared with patients with overweight, the following indicators were significantly lower: the average ratio of 6MWD/6MWD (i) (p = 0.0121), the level of oxygen saturation after 6-minute walking test, % of fat, and % of muscle. A direct correlation was observed between 6MWD and BMI (r = 0.54, p = 0.002), and between 6MWD and % of muscles (r = 0.58, p = 0.012).

Conclusion. Overweight patients with COPD have a higher exercise tolerance compared with patients with normal body weight, which can be partly explained by differences in the body composition with a significantly lower percentage of muscle mass in patients with normal body weight.

1. Ots O.N., Maliev B.M., Chushkin M.I., Mandrykin Yu.V., Yartsev S.S. Walk tests in pulmonology. Terapevticheskiy Arkhiv, 2012, vol. 84, no. 3, pp. 62-67. (In Russ.)

2. Tokmachev R.E., Maksimov А.V., Budnevskiy А.V., Batischeva G.А., Ovsyannikov E.S., Kravchenko А.Ya., Kurgalin S.D. Patent of Russia no. 2 637 917, 2017, Bull. no. 34. Ustroystvo dlya kardiorespiratornogo analiza i sposob otsenki kardiorespiratornogo sostoyaniya. [The device for cardiorespiratory analysis and the way to assess cardiorespiratory state].

3. Cooper C.B. The connection between chronic obstructive pulmonary disease symptoms and hyperinflation and its impact on exercise and function. Am. J. Med., 2006, vol. 119, (10 suppl. 1), pp. 21-31. doi: 10.1016/j.amjmed.2006.08.004.

4. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of COPD. Available: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf. Accessed 20 January 2019.

5. Kalantar-Zadeh K., Horwich T.B., Oreopoulos A., Kovesdy C.P., Younessi H., Anker S.D., Morley J.E. Risk factor paradox in wasting diseases. Curr. Opin. Clin. Nutr. Metab. Care, 2007, vol. 10, no. 4, pp. 433-442. doi: 10.1097/mco.0b013e3281a30594.

6. O'Donnell D.E., O'Donnell C.D., Webb K.A., Guenette J.A. Respiratory Consequences of Mild-to-Moderate Obesity: Impact on Exercise Performance in Health and in Chronic Obstructive Pulmonary Disease. Pulm. Med., 2012, 818925, doi: 10.1155/2012/818925.

7. Salome C.M., King G.G., Berend N. Physiology of obesity and effects on lung function. J. Appl. Physiol., 2010, vol. 108, no. 1, pp. 206-211. doi: 10.1152/japplphysiol.00694.2009.

8. Sin D.D., Jones R.L., Man S.F. Obesity is a risk factor for dyspnea but not for airflow obstruction. Arch. Intern. Med., 2002, vol. 162, no. 13, pp. 1477-1481.DOI: 10.1001/archinte.162.13.1477.

9. Vanfleteren L.E., Spruit M.A., Groenen M., Gaffron S., van Empel V.P., Bruijnzeel P.L., Rutten E.P., Op't Roodt J., Wouters E.F., Franssen F.M. Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med., 2013, vol. 187, pp. 728-735. doi: 10.1164/rccm.201209-1665OC.

10. Vozoris N.T., O'Donnell D.E. Prevalence, risk factors, activity limitation and health care utilization of an obese, population‐based sample with chronic obstructive pulmonary disease. Can. Respir. J., 2012, vol. 19, pp. e18-е24. doi: 10.1155/2012/732618.