• Changhwan Kim, Joon Beom Seo, Sang Min Lee, Jae Seung Lee, Jin Won Huh, Jin Hwa Lee, Seung Won Ra, Ji-Hyun Lee, Eun-Kyung Kim, Tae-Hyung Kim, Woo Jin Kim, Sang-Min Lee, Sang Yeub Lee, Seong Yong Lim, Tae Rim Shin, Ho Il Yoon, Seung Soo Sheen, Yeon-Mok Oh, Yong Bum Park, and Sang-Do Lee.
• Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.
• Respiration. 2013 Jan 1; 86 (2): 109-16.

BackgroundTo date, no clinical parameter has been associated with the decline in lung function other than emphysema severity in COPD.ObjectivesThe main purpose of this study was to explore whether the rate of lung function decline differs between COPD patients with and without exertional desaturation.MethodsA total of 224 subjects were selected from the Korean Obstructive Lung Disease cohort. Exertional desaturation was assessed using the 6-min walk test (6MWT), and defined as a post-exercise oxygen saturation (SpO2) of < 90% or a ≥ 4% decrease. The cohort was divided into desaturator (n = 47) and non-desaturator (n = 177) groups.ResultsThere was a significant difference between the desaturator and non-desaturator groups in terms of the change in pre-bronchodilator forced expiratory volume in 1 s (FEV1) over a 3-year period of follow-up (p = 0.006). The mean rate of decline in FEV1 was greater in the desaturator group (33.8 ml/year) than in the non-desaturator group (11.6 ml/year). A statistically significant difference was also observed between the two groups in terms of the change in the St. George's Respiratory Questionnaire (SGRQ) total score over 3 years (p = 0.001).ConclusionsThis study suggests, for the first time, that exertional desaturation may be a predictor of rapid decline in lung function in patients with COPD. The 6MWT may be a useful test to predict a rapid lung function decline in COPD.Copyright © 2012 S. Karger AG, Basel.

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