Quality of life and its determinants in chronic obstructive pulmonary disease patients

Summary. The aim of this study was to investigate quality of life (QoL) in patients with COPD and relationships of QoL with bronchial obstruction, pulmonary hypertension (PH), myocardial remodeling, and systemic inflammation. The study involved 56 patients with chronic obstructive pulmonary disease (COPD) and 25 healthy controls. We assessed QoL by SF-36 questionnaire. PH, sizes of right and left ventricles and atria (RV, LV, RA, LA) and their dynamics during 2-year follow-up were assessed using echocardiography. Also, TNF-α and IL-6 concentrations were measured and spirometry was performed. Correlation analysis was performed. Patients were categorized as having "poor QoL" (n = 12) or "better QoL" (n = 44) and compared. All parameters of QoL were lower in COPD patients compared with controls (p < 0.001), especially in the Role-Physical Functioning domain (by 58.9 %, р < 0.0001). Poor QoL was associated with rapid and significant dilatation of LV, RA, and LA, diastolic LV dysfunction, elevated levels of serum TNF-α, IL-6, and creatinine; polycithaemia and lower FEV1 (p < 0.05) but not with PH. Therefore, all the QoL parameters were impaired in patients with COPD, especially physical health component. Heart remodeling, systemic inflammation, bronchial obstruction, polycythaemia and renal dysfunction appear to contribute to the QoL worsening. The impact of PH on QoL was less significant.