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Dr Arnab Maji Dr Avijit Kundu Prof. (Dr) Supriya Sarkar Dept of Respiratory Medicine

Correlation study between post- bronchodialator FEV 1 and six minute walk distance in chronic obstructive pulmonary disease patients. Dr Arnab Maji Dr Avijit Kundu Prof. (Dr) Supriya Sarkar Dept of Respiratory Medicine N.R.S. Medical College, Kolkata. Introduction .

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Dr Arnab Maji Dr Avijit Kundu Prof. (Dr) Supriya Sarkar Dept of Respiratory Medicine

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  1. Correlation study between post-bronchodialator FEV1 and six minute walk distance in chronic obstructive pulmonary disease patients Dr ArnabMaji Dr AvijitKundu Prof. (Dr) SupriyaSarkar Dept of Respiratory Medicine N.R.S. Medical College, Kolkata

  2. Introduction • Spirometric measurement of post-bronchodialator FEV1 is essential for assessment of severity (staging), to predict the outcome and to plan treatment. • The six-minute walk test (6MWT) is a simple, objective, and reproducible measurement of functional capacity of patients with chronic cardio-pulmonary impairment. • As per ATS guideline 6MWT is more reproducible than post-bronchodialator FEV1 • Spirometry is not available everywhere particularly in the rural areas of our country. • 6MWT is easy to perform and may be done at almost any set-up.

  3. Background • Spirometry is of immense help in the diagnosis, staging and management of COPD but it is not available in most of the rural set-ups in India. • 6MWT is a simple, reproducible test and can be performed by majority of patients who are unable to perform spirometry and areas where spirometry is not available. • There are many studies conducted world wide showing 6MWT correlated well with different spirometric indices particularly post-bronchodialator FEV1 in predicting severity of COPD1,3. • One Indian study by Mehta et al2 also showed definite correlation between spirometric indices and 6MWD.

  4. Inclusion Criteria • COPD patients attending OPD diagnosed by clinical and spirometric criteria (post bronchodilator FEV1 / FVC ratio <70%) as per GOLD CRITERIA

  5. Exclusion Criteria • Unstable patient as per clinical assessment. • Patient with clinical or radiological evidence of Pneumonia. • Patient with Blood Pressure ≥ 180/100mmHg and resting heart rate >120/min prior to 6 MWT. • Those with evidence of left ventricular failure (LVF), ischemic heartdisease (IHD) or any major cardiac disease. • Abnormal ECG. • Neuromuscular disease of the lower extremities. • Peripheral Vascular Disease. • Those who refuse to give informed written Consent.

  6. Materials

  7. Methods

  8. Six minute walk test

  9. RESULTS

  10. Age and Sex Dustribution of study population

  11. Bar-diagram showing age and sex distribution

  12. Staging of COPD as per GOLD criteria

  13. Bar diagram showing distribution of stages of COPD

  14. Mean and standard deviation of 6MWD values among different GOLD staging

  15. Scatter diagram showing relation between post-FEV1 and 6MWD

  16. Correlation of PEFR and 6MWD ANOVA F= 15.622 R = 0.408, p<0.001

  17. Correlation of FVC and 6MWD

  18. Conclusion • Hence 6MWT may be done as a substitute for spirometry.

  19. Limitation of the Study • Sample size is small • No control was taken

  20. References • RoozbehNaghshin, Mohammad MassoodZaker, and AminEhteshamiAfshar. Association between Six-Minute Walk Test and Expiratory Spirometry Parameters in Chronic Obstructive Pulmonary Disease. Iranian Heart Journal 2005; 6 (3): 59-63 • Mehta Asmita, KumariIndira K.S. Correlation of Six Minute Walk Test with Spirometry and DLCO in Chronic Respiratory Diseases: Pulmon 2011;13(2). • C. Casanova, C.G. Cote et al. The 6-min walking distance: long-term follow up in patients with COPD. EurRespir J 2007; 29: 535–540.

  21. THANK YOU

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