Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 4;8(1):42.
doi: 10.3390/jcm8010042.

Effort Oxygen Saturation and Effort Heart Rate to Detect Exacerbations of Chronic Obstructive Pulmonary Disease or Congestive Heart Failure

César Gálvez-Barrón  1 , Felipe Villar-Álvarez  2 , Jesús Ribas  3 , Francesc Formiga  4 , David Chivite  5 , Ramón Boixeda  6 , Cristian Iborra  7 , Alejandro Rodríguez-Molinero  8
Affiliations

Effort Oxygen Saturation and Effort Heart Rate to Detect Exacerbations of Chronic Obstructive Pulmonary Disease or Congestive Heart Failure

César Gálvez-Barrón et al. J Clin Med. .

Abstract

Background: current algorithms for the detection of heart failure (HF) and chronic obstructive pulmonary disease (COPD) exacerbations have poor performance.

Methods: this study was designed as a prospective longitudinal trial. Physiological parameters were evaluated at rest and effort (walking) in patients who were in the exacerbation or stable phases of HF or COPD. Parameters with relevant discriminatory power (sensitivity (Sn) or specificity (Sp) ≥ 80%, and Youden index ≥ 0.2) were integrated into diagnostic algorithms.

Results: the study included 127 patients (COPD: 56, HF: 54, both: 17). The best algorithm for COPD included: oxygen saturation (SaO₂) decrease ≥ 2% in minutes 1 to 3 of effort, end-of-effort heart rate (HR) increase ≥ 10 beats/min and walking distance decrease ≥ 35 m (presence of one criterion showed Sn: 0.90 (95%, CI(confidence interval): 0.75⁻0.97), Sp: 0.89 (95%, CI: 0.72⁻0.96), and area under the curve (AUC): 0.92 (95%, CI: 0.85⁻0.995)); and for HF: SaO₂ decrease ≥ 2% in the mean-of-effort, HR increase ≥ 10 beats/min in the mean-of-effort, and walking distance decrease ≥ 40 m (presence of one criterion showed Sn: 0.85 (95%, CI: 0.69⁻0.93), Sp: 0.75 (95%, CI: 0.57⁻0.87) and AUC 0.84 (95%, CI: 0.74⁻0.94)).

Conclusions: effort situations improve the validity of physiological parameters for detection of HF and COPD exacerbation episodes.

Keywords: chronic obstructive pulmonary disease; diagnostic algorithms; heart failure.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest; the funders had no role in study design, data collection, analysis and interpretation, decision to publish the results, or preparation of the manuscript.

Figures

Figure 1
Figure 1
Timeline for evaluation sessions during the trial.
Figure 2
Figure 2
Participant recruiting and follow-up.
Figure 3
Figure 3
HR and SaO2 during evaluation sessions. (a,b): SaO2 and HR of HF patients, respectively; (c,d): SaO2 and HR of COPD patients, respectively.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Boult C., Altmann M., Gilbertson D., Yu C., Kane R.L. Decreasing disability in the 21st century: The future effects of controlling six fatal and nonfatal conditions. Am. J. Public Health. 1996;86:1388–1393. doi: 10.2105/AJPH.86.10.1388. - DOI - PMC - PubMed
    1. Mannino D.M. COPD: Epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest. 2002;121(Suppl. 5):121S–126S. doi: 10.1378/chest.121.5_suppl.121S. - DOI - PubMed
    1. MuñizGarcía J., Crespo Leiro M.G., Castro Beiras A. Epidemiology of heart failure in Spain and the importance of adhering to clinical practice guidelines. Rev. Esp. Cardiol. 2006;6(Suppl. F):2–8. - PubMed
    1. Anzueto A., Sethi S., Martinez F.J. Exacerbations of chronic obstructive pulmonary disease. Proc. Am. Thorac. Soc. 2007;4:554–564. doi: 10.1513/pats.200701-003FM. - DOI - PubMed
    1. Giamouzis G., Kalogeropoulos A., Georgiopoulou V., Laskar S., Smith A.L., Dunbar S., Triposkiadis F., Butler J. Hospitalization epidemic in patients with heart failure: Risk factors, risk prediction, knowledge gaps, and future directions. J. Card. Fail. 2011;17:54–75. doi: 10.1016/j.cardfail.2010.08.010. - DOI - PubMed