Source: Annual Congress 2003 - COPD: a multicomponent disease
Disease area: Airway diseases

Abstract

We studied the relationship between sympathetic nervous stress during exercise and the prognosis in terms of survival time in patients with COPD in the prospective cohort protocol. The concentration of plasma norepinephrine (NA) in COPD patients with symptoms of exertional dyspnea had been estimated during cardiopulmonary exercise testing (CPET) using a treadmill. The ninety-nine patients were followed up in our institute during the 3 to 5 year period after CPET. Twenty-three of these patients (23.2%) died. Sympathetic nervous stress (which was estimated using the ΔNA/Δ oxygen uptake ratio and the NA threshold during exercise) was significantly associated with the survival time. In a multiple regression analysis, ΔNA/Δ oxygen uptake ratio was a significant independent prognostic predictor from other predictors of COPD, such as %FEV1, BMI and so on. These results revealed that the acceleration of the sympathetic nervous system during light exercise is a good prognostic predictor in patients with COPD.

Univariate and multivariate analysis on survival of patients with COPD

	univariate hazard ratio (95%CI)	p-value	multivariate hazard ratio (95%CI)	p-value
ΔNA/Δoxygen uptake ratio	4.8 (2.39 - 9.63)	<0.0001	2.98 (1.3 - 6.8)	<0.01
%FEV1	0.96 (0.92 - 0.99)	0.03	0.97 (0.93 - 1.01)	ns
BMI	0.82 (0.71 - 0.94)	0.006	0.85 (0.73 - 0.98)	0.03
Pao2 (mmHG)	0.96 (0.92 - 0.995)	0.03	0.996 (0.96 - 1.03)	ns

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Citations should be made in the following way:
K. Yoshimura, R. Maekura, T. Hiraga, Y. Okuda, A. Hirotani, M. Itou (Toyonaka, Japan). Sympathetic nervous stress during exercise is a good prognostic predictor in patients with COPD. Eur Respir J 2003; 22: Suppl. 45, 3376

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