Chronotropic index during 6-minute walk and acute respiratory events in COPDGene

David M. Macdonald; Elise F. Palzer; Asghar Abbasi; Arianne K. Baldomero; Surya P. Bhatt; Richard Casaburi; John E. Connett; Mark T. Dransfield; Nathaniel T. Gaeckle; Takudzwa Mkorombindo; Harry B. Rossiter; William W. Stringer; Nicholas B. Tiller; Chris H. Wendt; Dongxing Zhao; Ken M. Kunisaki

doi:10.1016/j.rmed.2022.106775

Chronotropic index during 6-minute walk and acute respiratory events in COPDGene

David M. Macdonald, Elise F. Palzer, Asghar Abbasi, Arianne K. Baldomero, Surya P. Bhatt, Richard Casaburi, John E. Connett, Mark T. Dransfield, Nathaniel T. Gaeckle, Takudzwa Mkorombindo, Harry B. Rossiter, William W. Stringer, Nicholas B. Tiller, Chris H. Wendt, Dongxing Zhao, Ken M. Kunisaki

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: Lower heart rate (HR) increases during exercise and slower HR recovery (HRR) after exercise are markers of worse autonomic function that may be associated with risk of acute respiratory events (ARE). Methods: Data from 6-min walk testing (6MWT) in COPDGene were used to calculate the chronotropic index (CI) [(HR immediately post 6MWT – resting HR)/((220 – age) – resting HR)] and HRR at 1 min after 6MWT completion. We used zero-inflated negative binomial regression to test associations of CI and HRR with rates of any ARE (requiring steroids and/or antibiotics) and severe ARE (requiring emergency department visit or hospitalization), among all participants and in spirometry subgroups (normal, chronic obstructive pulmonary disease [COPD], and preserved ratio with impaired spirometry). Results: Among 4,484 participants, mean follow-up time was 4.1 years, and 1,966 had COPD. Among all participants, CI-6MWT was not associated with rate of any ARE [adjusted incidence rate ratio (aIRR) 0.98 (0.95–1.01)], but higher CI-6MWT was associated with lower rate of severe ARE [0.95 (0.92–0.99)]. Higher HRR was associated with a lower rate of both any ARE [0.97 (0.95–0.99)] and severe ARE [0.95 (0.92–0.98)]. Results were similar in the COPD spirometry subgroup. Conclusion: Heart rate measures derived from 6MWT tests may have utility in predicting risk of acute respiratory events and COPD exacerbations.

Original language	English (US)
Article number	106775
Journal	Respiratory Medicine
Volume	194
DOIs	https://doi.org/10.1016/j.rmed.2022.106775
State	Published - Apr 2022

Bibliographical note

Funding Information:
The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an Industry Advisory Board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion.

Funding Information:
AA, AKB, NTG, DMM, TM, DZ, CW, and NBT have nothing to declare. Outside of this work, SPB has received grant support from the NIH and Sanofi, and consulting/advisory board fees from Sunovion, GlaxoSmithKline, Sanofi, Boehringer Ingelheim, and Vigor Medical System. Outside of this work, RC has received grant support, advisory board fees, and lecture fees from GlaxoSmithKline, Boehringer Ingelheim, and AstraZeneca, consulting fees from Regeneron and Genentech, and reports owning stock in Inogen. Outside of this work, JEC has received grant support from the Department of Defense. Outside of this work, MTD has received consulting fees and served on clinical trials for Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Teva, CSA Medical, and PneumRx/BTG, served on clinical trials for Novartis, Yungjin, Boston Scientific, Gala Therapeutics, and Nuvaira, received travel support and served on clinical trials for Pulmonx, and received consulting fees from Quark Pharmaceuticals and Mereo. Outside of this work, KMK has received consulting fees from Nuvaria and Allergan. Outside this work, EP has received support from the National Institutes of Health. Outside of this work, HBR reports consulting fees from Omniox Inc., and is involved in contracted clinical research with Boehringer Ingelheim, GlaxoSmithKline, Novartis, AstraZeneca, Astellas, United Therapeutics, Genentech and Regeneron. He is a visiting Professor at the University of Leeds, UK. Outside of this work, WWS has received grant support from Department of Defense, AstraZeneca, and Boehringer Ingelheim, and consulting fees for serving on a DSMB for GlaxoSmithKline.

Funding Information:
DMM was supported by the University of Minnesota T32 Training in Lung Science training grant (2T32HL007741-26A1). AA was supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. 28FT-0017). AKB was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grants KL2TR002492 and UL1TR002494. HBR is supported by grants from NIH (R01HL151452, P50HD098593, R01DK122767, P2CHD086851, R01HL153460), the Tobacco Related Disease Research Program (T31IP1666), and the University of California, Office of the President. NBT is supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. T31FT1692). This material is also the result of work supported with resources and the use of facilities at the Minneapolis Veterans Affairs Medical Center, Minneapolis/USA.This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an Industry Advisory Board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion.

Funding Information:
This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.

Funding Information:
DMM was supported by the University of Minnesota T32 Training in Lung Science training grant ( 2T32HL007741-26A1 ). AA was supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. 28FT-0017). AKB was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grants KL2TR002492 and UL1TR002494 . HBR is supported by grants from NIH ( R01HL151452 , P50HD098593 , R01DK122767 , P2CHD086851 , R01HL153460 ), the Tobacco Related Disease Research Program ( T31IP1666 ), and the University of California, Office of the President . NBT is supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. T31FT1692). This material is also the result of work supported with resources and the use of facilities at the Minneapolis Veterans Affairs Medical Center, Minneapolis/USA.

Publisher Copyright:
© 2022

Keywords

Cardiac chronotropy
Chronic obstructive
Cohort study
Disease exacerbation
Pulmonary disease
Spirometry
Walking
Exercise Test
Exercise Tolerance/physiology
Humans
Pulmonary Disease, Chronic Obstructive
Walk Test

PubMed: MeSH publication types

Research Support, Non-U.S. Gov't
Journal Article
Research Support, N.I.H., Extramural

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.rmed.2022.106775

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Macdonald, D. M., Palzer, E. F., Abbasi, A., Baldomero, A. K., Bhatt, S. P., Casaburi, R., Connett, J. E., Dransfield, M. T., Gaeckle, N. T., Mkorombindo, T., Rossiter, H. B., Stringer, W. W., Tiller, N. B., Wendt, C. H., Zhao, D., & Kunisaki, K. M. (2022). Chronotropic index during 6-minute walk and acute respiratory events in COPDGene. Respiratory Medicine, 194, Article 106775. https://doi.org/10.1016/j.rmed.2022.106775

Macdonald, DM, Palzer, EF, Abbasi, A, Baldomero, AK, Bhatt, SP, Casaburi, R, Connett, JE, Dransfield, MT, Gaeckle, NT, Mkorombindo, T, Rossiter, HB, Stringer, WW, Tiller, NB, Wendt, CH, Zhao, D & Kunisaki, KM 2022, 'Chronotropic index during 6-minute walk and acute respiratory events in COPDGene', Respiratory Medicine, vol. 194, 106775. https://doi.org/10.1016/j.rmed.2022.106775

@article{caa6b1c5c90f4040af342d60fe921120,

title = "Chronotropic index during 6-minute walk and acute respiratory events in COPDGene",

abstract = "Background: Lower heart rate (HR) increases during exercise and slower HR recovery (HRR) after exercise are markers of worse autonomic function that may be associated with risk of acute respiratory events (ARE). Methods: Data from 6-min walk testing (6MWT) in COPDGene were used to calculate the chronotropic index (CI) [(HR immediately post 6MWT – resting HR)/((220 – age) – resting HR)] and HRR at 1 min after 6MWT completion. We used zero-inflated negative binomial regression to test associations of CI and HRR with rates of any ARE (requiring steroids and/or antibiotics) and severe ARE (requiring emergency department visit or hospitalization), among all participants and in spirometry subgroups (normal, chronic obstructive pulmonary disease [COPD], and preserved ratio with impaired spirometry). Results: Among 4,484 participants, mean follow-up time was 4.1 years, and 1,966 had COPD. Among all participants, CI-6MWT was not associated with rate of any ARE [adjusted incidence rate ratio (aIRR) 0.98 (0.95–1.01)], but higher CI-6MWT was associated with lower rate of severe ARE [0.95 (0.92–0.99)]. Higher HRR was associated with a lower rate of both any ARE [0.97 (0.95–0.99)] and severe ARE [0.95 (0.92–0.98)]. Results were similar in the COPD spirometry subgroup. Conclusion: Heart rate measures derived from 6MWT tests may have utility in predicting risk of acute respiratory events and COPD exacerbations.",

keywords = "Cardiac chronotropy, Chronic obstructive, Cohort study, Disease exacerbation, Pulmonary disease, Spirometry, Walking, Exercise Test, Exercise Tolerance/physiology, Humans, Pulmonary Disease, Chronic Obstructive, Walk Test",

author = "Macdonald, {David M.} and Palzer, {Elise F.} and Asghar Abbasi and Baldomero, {Arianne K.} and Bhatt, {Surya P.} and Richard Casaburi and Connett, {John E.} and Dransfield, {Mark T.} and Gaeckle, {Nathaniel T.} and Takudzwa Mkorombindo and Rossiter, {Harry B.} and Stringer, {William W.} and Tiller, {Nicholas B.} and Wendt, {Chris H.} and Dongxing Zhao and Kunisaki, {Ken M.}",

note = "Funding Information: The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an Industry Advisory Board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion. Funding Information: AA, AKB, NTG, DMM, TM, DZ, CW, and NBT have nothing to declare. Outside of this work, SPB has received grant support from the NIH and Sanofi, and consulting/advisory board fees from Sunovion, GlaxoSmithKline, Sanofi, Boehringer Ingelheim, and Vigor Medical System. Outside of this work, RC has received grant support, advisory board fees, and lecture fees from GlaxoSmithKline, Boehringer Ingelheim, and AstraZeneca, consulting fees from Regeneron and Genentech, and reports owning stock in Inogen. Outside of this work, JEC has received grant support from the Department of Defense. Outside of this work, MTD has received consulting fees and served on clinical trials for Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Teva, CSA Medical, and PneumRx/BTG, served on clinical trials for Novartis, Yungjin, Boston Scientific, Gala Therapeutics, and Nuvaira, received travel support and served on clinical trials for Pulmonx, and received consulting fees from Quark Pharmaceuticals and Mereo. Outside of this work, KMK has received consulting fees from Nuvaria and Allergan. Outside this work, EP has received support from the National Institutes of Health. Outside of this work, HBR reports consulting fees from Omniox Inc., and is involved in contracted clinical research with Boehringer Ingelheim, GlaxoSmithKline, Novartis, AstraZeneca, Astellas, United Therapeutics, Genentech and Regeneron. He is a visiting Professor at the University of Leeds, UK. Outside of this work, WWS has received grant support from Department of Defense, AstraZeneca, and Boehringer Ingelheim, and consulting fees for serving on a DSMB for GlaxoSmithKline. Funding Information: DMM was supported by the University of Minnesota T32 Training in Lung Science training grant (2T32HL007741-26A1). AA was supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. 28FT-0017). AKB was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grants KL2TR002492 and UL1TR002494. HBR is supported by grants from NIH (R01HL151452, P50HD098593, R01DK122767, P2CHD086851, R01HL153460), the Tobacco Related Disease Research Program (T31IP1666), and the University of California, Office of the President. NBT is supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. T31FT1692). This material is also the result of work supported with resources and the use of facilities at the Minneapolis Veterans Affairs Medical Center, Minneapolis/USA.This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an Industry Advisory Board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion. Funding Information: This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences. Funding Information: DMM was supported by the University of Minnesota T32 Training in Lung Science training grant ( 2T32HL007741-26A1 ). AA was supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. 28FT-0017). AKB was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grants KL2TR002492 and UL1TR002494 . HBR is supported by grants from NIH ( R01HL151452 , P50HD098593 , R01DK122767 , P2CHD086851 , R01HL153460 ), the Tobacco Related Disease Research Program ( T31IP1666 ), and the University of California, Office of the President . NBT is supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. T31FT1692). This material is also the result of work supported with resources and the use of facilities at the Minneapolis Veterans Affairs Medical Center, Minneapolis/USA. Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = apr,

doi = "10.1016/j.rmed.2022.106775",

language = "English (US)",

volume = "194",

journal = "Respiratory Medicine",

issn = "0954-6111",

publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Chronotropic index during 6-minute walk and acute respiratory events in COPDGene

AU - Macdonald, David M.

AU - Palzer, Elise F.

AU - Abbasi, Asghar

AU - Baldomero, Arianne K.

AU - Bhatt, Surya P.

AU - Casaburi, Richard

AU - Connett, John E.

AU - Dransfield, Mark T.

AU - Gaeckle, Nathaniel T.

AU - Mkorombindo, Takudzwa

AU - Rossiter, Harry B.

AU - Stringer, William W.

AU - Tiller, Nicholas B.

AU - Wendt, Chris H.

AU - Zhao, Dongxing

AU - Kunisaki, Ken M.

N1 - Funding Information: The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an Industry Advisory Board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion. Funding Information: AA, AKB, NTG, DMM, TM, DZ, CW, and NBT have nothing to declare. Outside of this work, SPB has received grant support from the NIH and Sanofi, and consulting/advisory board fees from Sunovion, GlaxoSmithKline, Sanofi, Boehringer Ingelheim, and Vigor Medical System. Outside of this work, RC has received grant support, advisory board fees, and lecture fees from GlaxoSmithKline, Boehringer Ingelheim, and AstraZeneca, consulting fees from Regeneron and Genentech, and reports owning stock in Inogen. Outside of this work, JEC has received grant support from the Department of Defense. Outside of this work, MTD has received consulting fees and served on clinical trials for Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Teva, CSA Medical, and PneumRx/BTG, served on clinical trials for Novartis, Yungjin, Boston Scientific, Gala Therapeutics, and Nuvaira, received travel support and served on clinical trials for Pulmonx, and received consulting fees from Quark Pharmaceuticals and Mereo. Outside of this work, KMK has received consulting fees from Nuvaria and Allergan. Outside this work, EP has received support from the National Institutes of Health. Outside of this work, HBR reports consulting fees from Omniox Inc., and is involved in contracted clinical research with Boehringer Ingelheim, GlaxoSmithKline, Novartis, AstraZeneca, Astellas, United Therapeutics, Genentech and Regeneron. He is a visiting Professor at the University of Leeds, UK. Outside of this work, WWS has received grant support from Department of Defense, AstraZeneca, and Boehringer Ingelheim, and consulting fees for serving on a DSMB for GlaxoSmithKline. Funding Information: DMM was supported by the University of Minnesota T32 Training in Lung Science training grant (2T32HL007741-26A1). AA was supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. 28FT-0017). AKB was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grants KL2TR002492 and UL1TR002494. HBR is supported by grants from NIH (R01HL151452, P50HD098593, R01DK122767, P2CHD086851, R01HL153460), the Tobacco Related Disease Research Program (T31IP1666), and the University of California, Office of the President. NBT is supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. T31FT1692). This material is also the result of work supported with resources and the use of facilities at the Minneapolis Veterans Affairs Medical Center, Minneapolis/USA.This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences.The project described was supported by Award Number U01 HL089897 and Award Number U01 HL089856 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an Industry Advisory Board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion. Funding Information: This research was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grant UL1TR002494 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health's National Center for Advancing Translational Sciences. Funding Information: DMM was supported by the University of Minnesota T32 Training in Lung Science training grant ( 2T32HL007741-26A1 ). AA was supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. 28FT-0017). AKB was supported by the National Institutes of Health's National Center for Advancing Translational Sciences , grants KL2TR002492 and UL1TR002494 . HBR is supported by grants from NIH ( R01HL151452 , P50HD098593 , R01DK122767 , P2CHD086851 , R01HL153460 ), the Tobacco Related Disease Research Program ( T31IP1666 ), and the University of California, Office of the President . NBT is supported by a postdoctoral fellowship from the Tobacco-Related Disease Research Program (TRDRP; award no. T31FT1692). This material is also the result of work supported with resources and the use of facilities at the Minneapolis Veterans Affairs Medical Center, Minneapolis/USA. Publisher Copyright: © 2022

PY - 2022/4

Y1 - 2022/4

N2 - Background: Lower heart rate (HR) increases during exercise and slower HR recovery (HRR) after exercise are markers of worse autonomic function that may be associated with risk of acute respiratory events (ARE). Methods: Data from 6-min walk testing (6MWT) in COPDGene were used to calculate the chronotropic index (CI) [(HR immediately post 6MWT – resting HR)/((220 – age) – resting HR)] and HRR at 1 min after 6MWT completion. We used zero-inflated negative binomial regression to test associations of CI and HRR with rates of any ARE (requiring steroids and/or antibiotics) and severe ARE (requiring emergency department visit or hospitalization), among all participants and in spirometry subgroups (normal, chronic obstructive pulmonary disease [COPD], and preserved ratio with impaired spirometry). Results: Among 4,484 participants, mean follow-up time was 4.1 years, and 1,966 had COPD. Among all participants, CI-6MWT was not associated with rate of any ARE [adjusted incidence rate ratio (aIRR) 0.98 (0.95–1.01)], but higher CI-6MWT was associated with lower rate of severe ARE [0.95 (0.92–0.99)]. Higher HRR was associated with a lower rate of both any ARE [0.97 (0.95–0.99)] and severe ARE [0.95 (0.92–0.98)]. Results were similar in the COPD spirometry subgroup. Conclusion: Heart rate measures derived from 6MWT tests may have utility in predicting risk of acute respiratory events and COPD exacerbations.

AB - Background: Lower heart rate (HR) increases during exercise and slower HR recovery (HRR) after exercise are markers of worse autonomic function that may be associated with risk of acute respiratory events (ARE). Methods: Data from 6-min walk testing (6MWT) in COPDGene were used to calculate the chronotropic index (CI) [(HR immediately post 6MWT – resting HR)/((220 – age) – resting HR)] and HRR at 1 min after 6MWT completion. We used zero-inflated negative binomial regression to test associations of CI and HRR with rates of any ARE (requiring steroids and/or antibiotics) and severe ARE (requiring emergency department visit or hospitalization), among all participants and in spirometry subgroups (normal, chronic obstructive pulmonary disease [COPD], and preserved ratio with impaired spirometry). Results: Among 4,484 participants, mean follow-up time was 4.1 years, and 1,966 had COPD. Among all participants, CI-6MWT was not associated with rate of any ARE [adjusted incidence rate ratio (aIRR) 0.98 (0.95–1.01)], but higher CI-6MWT was associated with lower rate of severe ARE [0.95 (0.92–0.99)]. Higher HRR was associated with a lower rate of both any ARE [0.97 (0.95–0.99)] and severe ARE [0.95 (0.92–0.98)]. Results were similar in the COPD spirometry subgroup. Conclusion: Heart rate measures derived from 6MWT tests may have utility in predicting risk of acute respiratory events and COPD exacerbations.

KW - Cardiac chronotropy

KW - Chronic obstructive

KW - Cohort study

KW - Disease exacerbation

KW - Pulmonary disease

KW - Spirometry

KW - Walking

KW - Exercise Test

KW - Exercise Tolerance/physiology

KW - Humans

KW - Pulmonary Disease, Chronic Obstructive

KW - Walk Test

UR - http://www.scopus.com/inward/record.url?scp=85124955428&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85124955428&partnerID=8YFLogxK

U2 - 10.1016/j.rmed.2022.106775

DO - 10.1016/j.rmed.2022.106775

M3 - Article

C2 - 35203009

AN - SCOPUS:85124955428

SN - 0954-6111

VL - 194

JO - Respiratory Medicine

JF - Respiratory Medicine

M1 - 106775

ER -

Chronotropic index during 6-minute walk and acute respiratory events in COPDGene

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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