Correlações entre o índice BODE e variáveis máximas de esforço em pacientes com DPOC
Correlation between the BODE index and variables of maximal exercise capacity in patients with COPD
Vinicius Cavalheri, Leandro Cruz Mantoani, Carlos Augusto Camillo, Fabio Pitta
Resumo
Introdução: Tanto o índice BODE quanto o pico de consumo de oxigênio (VO2 pico), uma das variáveis máximas de esforço, são preditores de morbidade e mortalidade de pacientes com doença pulmonar obstrutiva crônica (DPOC). Contudo, pouco se conhece sobre associações entre o índice BODE e variáveis máximas de esforço. Objetivos: Investigar correlações entre variáveis máximas de esforço e o índice BODE existentes em pacientes com DPOC. Métodos: Sessenta pacientes com DPOC (32 homens), com volume expiratório forçado no primeiro segundo (VEF1) 46±16%predito e idade 66±8anos foram submetidos a um teste cardiopulmonar máximo de esforço. Neste, foram coletados dados de potência máxima (Wmax), VO2 pico, volume minuto máximo (VEmax), frequência cardíaca máxima (FCmax), saturação periférica de oxigênio no repouso (SpO2 rep), no final (SpO2 f) e na fase de recuperação (SpO2 rec). Para caracterização da amostra e cálculo do índice BODE, os pacientes também foram submetidos às avaliações de função pulmonar (espirometria, com determinação do VEF1 ), dispneia percebida (escala modificada do Medical Research Council) e teste da caminhada de 6 minutos. Associações foram analisadas por meio de coeficientes de correlação simples (Pearson ou Spearman). Resultados: Correlações moderadas foram encontradas entre índice BODE com a Wmax, VO2 pico, VEmax, FCmax, SpO2 rep, SpO2 f e SpO2 rec (-0,27 ≤ r ≤ -0,51; p≤0,05 para todas). SpO2 rep e SpO2 rec correlacionaram-se com VO2 pico (r = 0,34 e 0,33, respectivamente; p=0,02 para ambos) e com a Wmax (r = 0,35 e 0,29, respectivamente; p=0,03). Conclusão: Melhor prognóstico de morbidade e mortalidade avaliado pelo índice BODE está moderadamente correlacionado com melhor capacidade máxima de esforço, oxigenação e recuperação após estresse máximo de pacientes com DPOC.
Palavras-chave
Abstract
Background: Both the BODE index and the peak rate of oxygen uptake (VO2 peak), one of the variables of maximal exercise capacity, are predictors of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). However, little is known about associations between the BODE index and variables of maximal exercise capacity. Objectives: To investigate correlations between variables of maximal exercise capacity and the BODE index in patients with COPD. Methods: Sixty patients with COPD (32 men), with forced expiratory volume in one second (FEV1 ) 46±16%predicted and age 66±8 years underwent a maximal cardiopulmonary exercise test (CPET). During the CPET measures were collected of: maximum workload (Wmax), VO2 peak, maximum minute ventilation (VEmax), maximal heart rate (HRmax), peripheral oxygen saturation at rest (SpO2 rest), at the end of the test (SpO2 end) and at recovery (SpO2 rec). In order to characterize the population and calculate the BODE index, patients were also submitted to assessment of lung function (spirometry, with FEV1 measurement), self-reported dyspnoea (Medical Research Council scale, modified version) and 6-minute walking distance. Pearson or Spearman correlation coefficients were used to verify possible associations. Results: The BODE index correlated with Wmax, VO2 peak, VEmax, HRmax, SpO2 rest, SpO2 end e SpO2 rec (-0.27 ≤ r ≤ -0.51; p≤0.05 for all). Regarding correlations amongst variables of maximal exercise capacity, the SpO2 rest and SpO2 rec correlated with VO2 peak (r = 0.34 and 0.33, respectively; p=0.02 for both) and with the Wmax (r = 0.35 and 0.29, respectively; p=0.03). Conclusions: Better morbidity and mortality prognostic values, as measured by the BODE index, are moderately related to maximal exercise capacity, oxygen saturation and recovery after maximal stress.
Keywords
Referências
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