Exercise ventilatory inefficiency in mild to end-stage COPD
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 intercep...
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| Veröffentlicht in: | The European respiratory journal 2015-02, Vol.45 (2), p.377-387 |
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| container_title | The European respiratory journal |
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| creator | Neder, J Alberto Arbex, Flavio F Alencar, Maria Clara N O'Donnell, Conor D J Cory, Julia Webb, Kathy A O'Donnell, Denis E |
| description | 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 |
| doi_str_mv | 10.1183/09031936.00135514 |
| format | Article |
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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.</description><identifier>ISSN: 0903-1936</identifier><identifier>EISSN: 1399-3003</identifier><identifier>DOI: 10.1183/09031936.00135514</identifier><identifier>PMID: 25359345</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Carbon Dioxide ; Case-Control Studies ; Disease Progression ; Dyspnea - physiopathology ; Exercise ; Exercise Test ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Gas Exchange ; Respiration ; Respiratory Function Tests ; Rest ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome</subject><ispartof>The European respiratory journal, 2015-02, Vol.45 (2), p.377-387</ispartof><rights>Copyright ©ERS 2015.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-b9678ca3e2ee8d8c1f0d9dca6d8bfb586921f07bd626091041b493ff41cbb4a53</citedby><cites>FETCH-LOGICAL-c443t-b9678ca3e2ee8d8c1f0d9dca6d8bfb586921f07bd626091041b493ff41cbb4a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25359345$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neder, J Alberto</creatorcontrib><creatorcontrib>Arbex, Flavio F</creatorcontrib><creatorcontrib>Alencar, Maria Clara N</creatorcontrib><creatorcontrib>O'Donnell, Conor D J</creatorcontrib><creatorcontrib>Cory, Julia</creatorcontrib><creatorcontrib>Webb, Kathy A</creatorcontrib><creatorcontrib>O'Donnell, Denis E</creatorcontrib><title>Exercise ventilatory inefficiency in mild to end-stage COPD</title><title>The European respiratory journal</title><addtitle>Eur Respir J</addtitle><description>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.</description><subject>Aged</subject><subject>Carbon Dioxide</subject><subject>Case-Control Studies</subject><subject>Disease Progression</subject><subject>Dyspnea - physiopathology</subject><subject>Exercise</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary Gas Exchange</subject><subject>Respiration</subject><subject>Respiratory Function Tests</subject><subject>Rest</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><issn>0903-1936</issn><issn>1399-3003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtOwzAQRS0EoqXwAWxQlmxSPPEjtlihUh5SpbKAdRTbY2SUB8Qpon9PorZsWY1m5ty7OIRcAp0DKHZDNWWgmZxTCkwI4EdkCkzrlFHKjsl0_KcjMCFnMX4MlOQMTskkE0xoxsWU3C5_sLMhYvKNTR-qsm-7bRIa9D7YgI0dl6QOlUv6NsHGpbEv3zFZrF_uz8mJL6uIF_s5I28Py9fFU7paPz4v7lap5Zz1qdEyV7ZkmCEqpyx46rSzpXTKeCOU1Nlwyo2TmaQaKAfDNfOegzWGl4LNyPWu97NrvzYY-6IO0WJVlQ22m1iAokqyDPLsf1SKjAvBaT6gsENt18bYoS8-u1CX3bYAWox6i4Pe4qB3yFzt6zemRveXOPhkvy46c2Q</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Neder, J Alberto</creator><creator>Arbex, Flavio F</creator><creator>Alencar, Maria Clara N</creator><creator>O'Donnell, Conor D J</creator><creator>Cory, Julia</creator><creator>Webb, Kathy A</creator><creator>O'Donnell, Denis E</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20150201</creationdate><title>Exercise ventilatory inefficiency in mild to end-stage COPD</title><author>Neder, J Alberto ; 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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.</abstract><cop>England</cop><pmid>25359345</pmid><doi>10.1183/09031936.00135514</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Carbon Dioxide Case-Control Studies Disease Progression Dyspnea - physiopathology Exercise Exercise Test Female Forced Expiratory Volume Humans Male Middle Aged Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary Gas Exchange Respiration Respiratory Function Tests Rest Retrospective Studies Severity of Illness Index Treatment Outcome |
| title | Exercise ventilatory inefficiency in mild to end-stage COPD |
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