Relatıonshıp between functıonal parameters and clınıcal exercıse tests ın patıents wıth stage 1 chronıc obstructıve pulmonary dısease

Aim: COPD, which is the main reason of mortality and morbidity and of which prevalance spreads gradually, still needs new approaches for diagnosis , and it?s also necessary to have clinical results and indications (symptoms) to determine severity of disease, to evaluate effectiveness of the treatment and by doing so, to analyse all aspect of the disease. FEV1 is used commonly to diagnose and determine severity of disease. However, there is a low correlation between clinical findings on the early stage and mortality stemming from COPD. It might be useful to determine and display validity of other criteriae which are more reasonable than FEV1. To this end, we studied if there is a difference in cardiopulmonary response between cases which have been diagnosed as stage 1 COPD according to GOLD criteriae and cases which are considered as a risk group to exercise.Method: All cases admitted to chest diseases outpatient clinic under the body of Dokuz Eylul University Medical Faculty (DEUMF) were analysed . Two different groups of cases were included in the study; one is composed of 40 cases followed with the diagnosis of stage 1 COPD according to GOLD criteria and just diagnosed without bronchodilator and antiinflammatory treatment while the other is composed of 52 cases with FEV1 / FVC > 70 % under risk that have appropriate smoking history with no systematic disease record affecting the respiratory system and not treated with bronchodilator and antinflammatory drugs postbronchodilator pulmonary function tests (PFR), 6 minute walking test (6 MWT) and cardiopulmonary exercise testing (CPET) were applied on each group.Results: When the cases with stage 1 COPD were compared with the group at risk, we determined that there is an exercise limitation. Our study on the exercise response types showed us that stage 1 COPD cases have exercise limitation at the very early stage. Taking into consideration the cases at risk, we found out that a limitation at early stage of exercise for the cases that keep smoking causes a limitation on the highest stage of exercise.Conclusion: Smoking history of cases with stage 1 COPD is apparently longer than those at risk. Intensive smoke exposure causes more serious pulmonary damage. Damage observed in stage 1 COPD occurs dominantly in peripheral airways. Ventilatory dysfunction likely to be associated with small airway disease seems to affects effort capacity. Methods, which can sensitively determine prevalence and severity of small airway disease, can be used together with spirometric measurements for the early diagnosis of COPD.