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J. Clin. Med. 2019, 8(1), 42; https://doi.org/10.3390/jcm8010042

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

1
Clinical Research Unit, Consorci Sanitari del Garraf, Sant Pere de Ribes, PC 08810 Barcelona, Spain
2
Department of Pulmonology, IIS Fundación Jiménez Díaz, CIBERES, UAM, PC 28040 Madrid, Spain
3
Servei de Pneumologia, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, PC 08907 Barcelona, Spain
4
Geriatric Unit. Internal Medicine Department, IDIBELL, Unversitat de Barcelona, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, PC 08907 Barcelona, Spain
5
Internal Medicine Department, Hospital de Mataró-Consorci Sanitari del Maresme, PC 08304 Barcelona, Spain
6
Cardiology Department, IIS Fundación Jiménez Díaz, PC 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
Received: 17 December 2018 / Accepted: 26 December 2018 / Published: 4 January 2019
(This article belongs to the Section Pulmonology)
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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. View Full-Text
Keywords: chronic obstructive pulmonary disease; heart failure; diagnostic algorithms chronic obstructive pulmonary disease; heart failure; diagnostic algorithms
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Gálvez-Barrón, C.; Villar-Álvarez, F.; Ribas, J.; Formiga, F.; Chivite, D.; Boixeda, R.; Iborra, C.; Rodríguez-Molinero, A. Effort Oxygen Saturation and Effort Heart Rate to Detect Exacerbations of Chronic Obstructive Pulmonary Disease or Congestive Heart Failure. J. Clin. Med. 2019, 8, 42.

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