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Alhaddad, Maath (2015) Cardiopulmonary manifestations in chronic obstructive pulmonary disease (COPD). PhD thesis, University of Nottingham.

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Abstract

Rationale

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition with extrapulmonary manifestations- cardiovascular diseases (CVD), impaired physical function, activity and increased frailty. Integrating measures of function into community assessments is hindered by the space and time required. The association of function, activity and CVD has not been extensively investigated in COPD.

Objectives

Explore the potential utility of Time Up and Go (TUG) as a measure of physical function in COPD

Assess association of non-invasive measures of haemodynamics to physical function and self-reported activity

Explore ambulatory haemodynamics in COPD and controls

Methods

Subjects with COPD (n=119) and controls (n=58) were recruited. Ethical and governance approvals were obtained. A medical history including falls, spirometry, peripheral and central haemodynamics, self-reported physical activity questionnaires and functional assessments (TUG and six-minute walk distance (6MWD)) were obtained from all subjects. Ambulatory 24-hour haemodynamics including aortic pulse wave velocity (aPWV) and blood pressure were measured in patients (n=20) and controls (n=19).

Results

TUG mean(SD) was increased in patients 11.9(3.7)s compared to controls 9.5(1.8)s, p<0.001. In patients, fallers had longer TUG than non-fallers (p=0.02) and a cut-off time of 12s had the highest sensitivity and specificity to detect fallers and non-fallers. Aortic stiffness was not associated to physical function or physical activity, p>0.05. In the pilot study, significant nocturnal dip in aPWV was seen in controls, p<0.01, but not in patients, p=0.07.

Conclusion

TUG could be a useful measure of function and possibly be incorporated into COPD assessment, particularly where time and space are limited. Finally, ambulatory haemodynamic machine, the Mobil-O-Graph, is feasible and offers opportunity to assess 24-hour haemodynamics profile including aPWV as opposed to a one-off measurement.

Item Type:	Thesis (University of Nottingham only) (PhD)
Supervisors:	Bolton, C. Harrison, T.W.
Keywords:	Function tests, Cardiovascular disease, Physical function, Ambulatory haemodynamics
Subjects:	W Medicine and related subjects (NLM Classification) > WF Respiratory system
Faculties/Schools:	UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID:	30008
Depositing User:	Alhaddad, Maath
Date Deposited:	12 Apr 2016 08:51
Last Modified:	14 Oct 2017 20:12
URI:	https://eprints.nottingham.ac.uk/id/eprint/30008

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