Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with many different phenotypes and many systemic manifestations, which contribute to its total morbidity and mortality. Cardiovascular disorders are the most frequently observed comorbidities, while the deterioration of pulmonary function is faster in the symptomatic stages of the disease independently of the stage and it accelerates after an exacerbation. Pulmonary rehabilitation is a documented therapeutic intervention with established benefits in these areas. The correlation between the outcomes of pulmonary rehabilitation program and the stage of the disease (A, B, C, D), the presence of symptoms (mMRC >2, CAT >10), the history of exacerbations (2 or at least 1 leading to a hospitalization) and cardiovascular comorbidity (Arterial hypertension, Coronary Heart Disease, Heart Failure, Arrhythmias, etc.).
Methods: Forty-one patients (♂/♀ =30/11) with COPD of different stages (A =3, B =7, C =2, D =29), symptomatic or not (36/5), with a history of exacerbations or not (17/24), with cardiovascular comorbidity or not (28/13), attended a comprehensive pulmonary rehabilitation program and were assessed as to the following parameters: mMRC, CAT, SGRQ, 6MWD, CPET.
Results: Statistically significant improvement was observed for all the patients of the study population as well for all the studied subgroups, for all the parameters of the assessment: mMRC (Mean pre =2.61, Mean post =1.80, SD =0.558, P<0.01), CAT (Mean pre =18.07, Mean post =13.71, SD =4.2, P<0.01), SGRQ (Mean pre =50.0773, Mean post =40.91, SD =10.26, P<0.01), 6MWD (Mean pre =269.98, Mean post =330.49, SD =41.41, P<0.01) except for the CPET, where there was clinically but not statistically significant improvement.
Conclusions: Pulmonary rehabilitation in COPD is effective independently of the stage of the disease, the presence of symptoms, the history of exacerbations, or the presence of cardiovascular comorbidity and thus it should be offered to all the patients independently of their phenotype.
