Patients on long-term oxygen therapy (LTOT) are commonly plagued with cardiovascular and metabolic problems. Indeed, they are usually ex-smokers and are affected by conditions such as COPD or pulmonary fibrosis carrying an important cardiovascular risk [1]. Furthermore, physical inactivity per se and vitamin D deficiency, both highly prevalent in hypoxemic COPD patients [2], negatively affect glucose metabolism and have a proinflammatory effect [3]. Older age also — the mean age of LTOT patients being 74 years [1] — qualifies as a risk factor for cardiovascular and metabolic conditions. Furthermore, hypoxemia induces hemodynamic and metabolic changes with important clinical effects (see next section). Finally, exacerbations of baseline respiratory conditions impact both the cardiovascular and metabolic status, with important effects on the inherent markers. We will summarize first the cardiovascular and metabolic effects of hypoxemia and try to distinguish them from problems related to the underlying respiratory conditions and related comorbidity. Then we will review the main diagnostic indices and how they fluctuate as a consequence of exacerbations, new comorbidities and pharmacologic interventions. The final section will be devoted to a very practical choice of indices useful for every day clinical practice.

Cardiovascular and Metabolic Indices

Pedone C;Scarlata S;Antonelli Incalzi R
2012-01-01

Abstract

Patients on long-term oxygen therapy (LTOT) are commonly plagued with cardiovascular and metabolic problems. Indeed, they are usually ex-smokers and are affected by conditions such as COPD or pulmonary fibrosis carrying an important cardiovascular risk [1]. Furthermore, physical inactivity per se and vitamin D deficiency, both highly prevalent in hypoxemic COPD patients [2], negatively affect glucose metabolism and have a proinflammatory effect [3]. Older age also — the mean age of LTOT patients being 74 years [1] — qualifies as a risk factor for cardiovascular and metabolic conditions. Furthermore, hypoxemia induces hemodynamic and metabolic changes with important clinical effects (see next section). Finally, exacerbations of baseline respiratory conditions impact both the cardiovascular and metabolic status, with important effects on the inherent markers. We will summarize first the cardiovascular and metabolic effects of hypoxemia and try to distinguish them from problems related to the underlying respiratory conditions and related comorbidity. Then we will review the main diagnostic indices and how they fluctuate as a consequence of exacerbations, new comorbidities and pharmacologic interventions. The final section will be devoted to a very practical choice of indices useful for every day clinical practice.
2012
978-88-470-2579-0
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12610/17034
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? ND
social impact