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Papadopoulos D, Skopas V, Trakas N, Papaefstathiou E, Tzogas N, Makris D, Daniil Z, Gourgoulianis K. Serum lactate dehydrogenase and its isoenzymes as predictors of clinical outcomes in acute exacerbation of chronic obstructive pulmonary disease: a retrospective analysis of a hospitalized cohort. Monaldi Arch Chest Dis 2023; 94. [PMID: 37284765 DOI: 10.4081/monaldi.2023.2543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
We aimed to test the relationship between serum lactate dehydrogenase (LDH) and its isoenzymes and treatment outcomes during hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Thirty-eight AECOPD patients were recruited from a tertiary hospital from December 2017 to June 2018. Serum LDH and LDH isoenzymes were measured on venous blood collected at admission. Treatment outcomes included duration of hospital stay, initiation of mechanical or non-invasive ventilation (NIV), initiation of antipseudomonal antibiotics, change in empirical antibiotic treatment, need for intravenous corticosteroids or methylxanthines, and percentage of change in C-reactive protein from admission to the third day. Multivariate linear and binary logistic regression analyses were used to test the study's objectives. We found that, after adjusting for age, gender, comorbidities, COPD severity, level of hypoxemia, and inflammation markers, each 10 U/L increase in serum LDH was associated with prolongation of the hospital stay by 0.25 (0.03, 0.46) days, 42% higher odds [odds ratio (OR) 1.42 (1.00, 2.03)] for need of NIV, and 25% higher odds [OR 1.25 (1.04, 1.49)] for initiation of antipseudomonal treatment. LDH1 and LDH2 were the LDH isoenzymes that mainly drove these relationships. LDH release in the context of an AECOPD could originate from lung, muscle, or heart tissue damage due to airway inflammation, respiratory muscle recruitment, and myocardial stress. Myocardial injury and aerobic adaptation in respiratory muscles may explain the predominance of LDH1 and LDH2 isoenzymes in these associations.
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Affiliation(s)
| | - Vlasios Skopas
- 2nd Pulmonary Medicine Department, "Sismanogleion" General Hospital of Attica, Marousi; Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa.
| | - Nikolaos Trakas
- Clinical Chemistry Department, "Sismanogleion" General Hospital of Attica, Marousi.
| | - Eleni Papaefstathiou
- Clinical Chemistry Department, "Sismanogleion" General Hospital of Attica, Marousi.
| | - Nikolaos Tzogas
- 3rd Pulmonary Medicine Department, Henry Dunant Hospital Center, Athens.
| | - Demosthenes Makris
- Critical Care Department, School of Medicine, University of Thessaly, University Hospital of Larissa.
| | - Zoe Daniil
- Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa.
| | - Konstantinos Gourgoulianis
- Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa.
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de Medeiros Nogueira MG, Silva GAG, Marinho MHT, de Fátima Costa Brito O, de Brito Vieira WH, Ururahy MAG, Nogueira IDB, da Silva IS, de Miranda Silva Nogueira PA. Acute effects of NIV on peripheral muscle function and aerobic performance in patients with chronic obstructive pulmonary disease: a pilot study. BMC Pulm Med 2022; 22:399. [PMID: 36333720 PMCID: PMC9635205 DOI: 10.1186/s12890-022-02201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Non-invasive ventilation (NIV) reduces respiratory load and demands on peripheral muscles. Methods This study aims to evaluate the acute effects of bi-level NIV on peripheral muscle function during isokinetic exercise and aerobic performance in chronic obstructive pulmonary disease (COPD) patients. This is a pilot crossover study performed with a non-probabilistic sample of 14 moderate to very severe COPD patients. Procedures carried out in two days. Dyspnea, quality of life, lung function, respiratory muscle strength, functional capacity (6-min walk test—6MWT), and isokinetic assessment of the quadriceps were assessed. Blood samples (lactate, lactate dehydrogenase, and creatine kinase concentration) were also collected. Right after, NIV was performed for 30 min (bi-level or placebo, according to randomization) followed by new blood sample collection, 6MWT, and isokinetic dynamometer tests. Before and after evaluations, the subjective perception of dyspnea and fatigue in the lower limbs was quantified. After a wash-out period of seven days, participants returned, and all assessments were performed again. Results NIV showed improvements in perceived exertion and dyspnea after isokinetic exercise (p < 0.02 and p < 0.05, respectively). Conclusions NIV improves the perception of dyspnea and fatigue during the isokinetic exercise.
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Affiliation(s)
- Mariana Galvão de Medeiros Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Gabriely Azevêdo Gonçalo Silva
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | | | - Ozana de Fátima Costa Brito
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Wouber Hérickson de Brito Vieira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Marcela Abbott Galvão Ururahy
- grid.411233.60000 0000 9687 399XDepartment of Clinical and Toxicological Analysis, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte Brazil
| | - Ivan Daniel Bezerra Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Ivanízia Soares da Silva
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
| | - Patrícia Angélica de Miranda Silva Nogueira
- grid.411233.60000 0000 9687 399XPhysiotherapy, Federal University of Rio Grande Do Norte, Av. Senador Salgado Filho, 3000, Candelária, Caixa Postal: 1524, Natal, Rio Grande Do Norte 59072970 Brazil
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Cruz J, Burtin C. Eccentric Exercise in COPD: Take It or Leave It? Chest 2021; 159:467-468. [PMID: 33563429 DOI: 10.1016/j.chest.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Joana Cruz
- Center for Innovative Care and Health Technology (ciTechcare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal.
| | - Chris Burtin
- Rehabilitation Research Center (REVAL), Biomedical Research Institute (BIOMED), Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Skopas V, Papadopoulos D, Trakas N, Papaefstathiou E, Koufopoulos C, Makris D, Daniil Z, Gourgoulianis K. Lactate dehydrogenase isoenzymes in patients with acute exacerbation of chronic obstructive pulmonary disease: An exploratory cross-sectional study. Respir Physiol Neurobiol 2020; 283:103562. [PMID: 33038523 DOI: 10.1016/j.resp.2020.103562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/18/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
We aimed to evaluate differences in serum lactate dehydrogenase (LDH) isoenzymes between patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and other lower respiratory tract infections (LRTIs). Based on self-reported COPD diagnosis, 71 participants were divided into AECOPD (n = 38, 29 males, mean age 70.5 years) and LRTI (n = 33, 12 males, mean age 70.4 years) groups. Information on demographics, comorbidities, and COPD severity markers, as well as arterial blood gases and laboratory data were collected, while serum LDH electrophoresis was performed to examine the LDH isoenzymes. Adjusting for sex, age, comorbidities, degree of hypoxemia, inflammation markers, muscle and myocardial enzymes, and total serum LDH, the mean differences (95 % confidence intervals) in the ratios of serum LDH isoenzymes to total serum LDH between groups (LDHxAECOPD - LDHxLRTI) were statistically significant for LDH1 [4.9 (1.4 to 8.3)], LDH2 [3.0 (0.1 to 5.8)], LDH3 [-4.3 (-6.3 to -2.3)], and LDH4 [-3.2 (-4.9 to -1.5)]. A sum of LDH3 and LDH4 ratios below 29 % had the highest discriminative ability to classify a subject in the AECOPD group (AUC 0.841, sensitivity 76 %, specificity 87 %). Aerobic metabolic adaptive mechanisms in respiratory muscles during AECOPD could explain the above differences.
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Affiliation(s)
- Vlasios Skopas
- 2nd Pulmonary Department, "Sismanogleion" General Hospital of Attica, Marousi, Greece; Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece.
| | | | - Nikolaos Trakas
- Clinical Chemistry Department, "Sismanogleion" General Hospital of Attica, Marousi, Greece
| | - Eleni Papaefstathiou
- Clinical Chemistry Department, "Sismanogleion" General Hospital of Attica, Marousi, Greece
| | | | - Demosthenes Makris
- Critical Care Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Zoe Daniil
- Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Konstantinos Gourgoulianis
- Respiratory Medicine Department, School of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
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