Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) are two chronic diseases that affect negatively the functional condition and quality of life of patients. We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients.</p><p><b>METHODS</b>The study included 42 COPD and 39 CHF patients. In both patient groups, dyspnea was assessed using Borg scale; functional capacity by shuttle-walk and cardiopulmonary exercise test and quality of life by short form-36 (SF36).</p><p><b>RESULTS</b>No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score, shuttle-walk test and the majority of subgroup scores of SF36 (P > 0.05). A statistically significant difference was observed in peak VO2 in favor of COPD group (P < 0.05). No significant relationship was established between dyspnea score and forced expiratory volume in one second (FEV1) in COPD patients, and left ventricular ejection fraction (LVEF) in CHF patients (P > 0.05). A significant negative correlation was observed between dyspnea score and functional capacity tests in both disease groups (P < 0.05). On the other hand, no relationship was found between LVEF and FEV1 and quality of life and functional capacity (P > 0.05).</p><p><b>CONCLUSIONS</b>It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups, however, objective indicators of disease severity do not show a similar relationship. Therefore, in addition to the objective data related to the disease, we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.</p>

effect of combination therapy on regression of left ventricular hypertrophy in cases with hypertension

Up to this date, it is well shown that several antihypertensive drugs have different regressive effect on left ventricular hypertrophy [LVH]. However, there are different studies regarding the effect of antihypertensive combination therapies on regression of LVH. In this study, 2 different combinations ACE-I plus calcium channel blocker and ACE-I plus diuretic were compared in cases with hypertension whose BPs were not controlled by ACE-I alone. Forty patients with mild to moderate hypertension were included in this study. The treatment was continued for 6 months in the Faculty of Medicine at Ege University, Turkey, between January and December 2003. Adequate response with lisinopril 20mg/daily failed to be achieved in all patients. Patients divided into 2 groups. There were no differences between the groups in patients' age, blood pressure [BP] and other clinical and laboratory range. First group patients received lisinopril 20mg + nifedipine GITS 30mg and second group patients received lisinopril 20mg + hydrochlorothiazide 25mg. The treatment was continued for 6 months. Blood pressure were measured every 2 weeks, echocardiographic findings, and blood and urinary analysis were performed before and at the end of treatment. Systolic and diastolic BP decreased significantly in both groups and no significant difference regarding BP was found between the 2 groups. Left ventricular mass index also decreased significantly in both groups. However, in the first group left ventricular mass index decreased more compared to the second group. The effect of combination therapies with angiotensin converting enzyme inhibitor [ACE-I] plus diuretic and ACE-I plus calcium channel blocker on systolic and diastolic BP are similar. However, when LVH is present, regressive effect of the combination of ACE-I plus calcium channel blocker is superior to the combination of ACE-I plus diuretic