Exercise ventilatory inefficiency in mild to end-stage COPD

Exercise ventilatory inefficiency in mild to end-stage COPD

Author Alberto Neder, J. Google Scholar
Arbex, Flavio F. Autor UNIFESP Google Scholar
Alencar, Maria Clara N. Autor UNIFESP Google Scholar
O'Donnell, Cpnor D. J. Google Scholar
Cory, Julia Google Scholar
Webb, Kathy A. Google Scholar
O'Donnell, Denis E. Google Scholar
Institution Queens Univ
Kingston Gen Hosp
Universidade Federal de São Paulo (UNIFESP)
Abstract Ventilatory inefficiency during exercise is a key pathophysiological feature of chronic obstructive pulmonary disease. Currently, it is unknown how this physiological marker relates to clinically relevant outcomes as resting ventilatory impairment progresses across disease stages.Slope and intercept of the linear region of the ventilation-carbon dioxide output relationship and the ratio between these variables, at the lowest point (nadir), were contrasted in 316 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1-4 (forced expiratory volume in 1 s, ranging from 148% pred to 12% pred) and 69 aged- and gender-matched controls,Compared to controls, slope and intercept were higher in GOLD stages 1 and 2, leading to higher nadirs (p<0.05). Despite even larger intercepts in GOLD stages 3 and 4, slopes diminished as disease evolved (from mean +/- SD 35 +/- 6 in GOLD stage 1 to 24 +/- 5 in GOLD stage 3, p<0.05). As a result, there were no significant differences in nadirs among patient groups. Higher intercepts, across all stages (p<0.01), and to a lesser extent lower slopes in GOLD stages 2-4 (p<0.05), were related to greater mechanical constraints, worsening pulmonary gas exchange, higher dyspnoea scores, and poorer exercise capacity.Increases in the ventilation intercept best indicate the progression of exercise ventilatory inefficiency across the whole spectrum of chronic obstructive pulmonary disease severity.
Language English
Date 2015-02-01
Published in European Respiratory Journal. Sheffield: European Respiratory Soc Journals Ltd, v. 45, n. 2, p. 377-387, 2015.
ISSN 0903-1936 (Sherpa/Romeo, impact factor)
Publisher European Respiratory Soc Journals Ltd
Extent 377-387
Origin http://dx.doi.org/10.1183/09031936.00135514
Access rights Closed access
Type Article
Web of Science ID WOS:000349509700015
URI http://repositorio.unifesp.br/handle/11600/38737

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