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Title: Does the respiratory system limit exercise in mild chronic obstructive pulmonary disease?
Authors: Roberto C. Chin
Jordan A. Guenette
Sicheng Cheng
Natya Raghavan
Naparat Amornputtisathaporn
Arturo Cortés-Télles
Katherine A. Webb
Denis E. O'Donnell
Kingston General Hospital
The University of British Columbia
McMaster University, Faculty of Health Sciences
Mahidol University
Keywords: Medicine
Issue Date: 15-Jun-2013
Citation: American Journal of Respiratory and Critical Care Medicine. Vol.187, No.12 (2013), 1315-1323
Abstract: Rationale: It is not knownif abnormal dynamic respiratory mechanics actually limit exercise in patients with mild chronic obstructive pulmonary disease (COPD). We reasoned that failure to increase peak ventilation and VT in response to dead space (DS) loading during exercise would indicate true ventilatory limitation to exercise in mild COPD. Objectives: To compare the effects of DS loading during exercise on ventilation, breathing pattern, operating lung volumes, and dyspnea intensity in subjects with mild symptomatic COPD and ageand sex-matched healthy control subjects. Methods: Twenty subjects with Global Initiative for Chronic Obstructive Lung Disease stage I COPD and 20 healthy subjects completed two symptom-limited incremental cycle exercise tests, in randomized order: unloaded control and added DS of 0.6 L. Measurements and Main Results: Peak oxygen uptake and ventilation were significantly lower in COPD than in health by 36% and 41%, respectively. With added DS compared with control, both groups had small decreases in peak work rate and no significant increase in peak ventilation. In health, peak VT and end-inspiratory lung volume increased significantly with DS. In contrast, the COPD group failed to increase peak end-inspiratory lung volume and had a significantly smaller increase in peak VT during DS. At 60 W, a 50% smaller increase inVT (P,0.001) in responsetoaddedDSinCOPDcompared with health was associated with a greater increase in dyspnea intensity (P = 0.0005). Conclusions: These results show that the respiratory system reached or approached its physiologic limit in mild COPD at a lower peak work rate and ventilation than in healthy participants. Copyright © 2013 by the American Thoracic Society.
ISSN: 15354970
Appears in Collections:Scopus 2011-2015

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