Advances in the Evaluation of Respiratory Pathophysiology during Exercise in Chronic Lung Diseases

O’Donnell, Denis E.; Elbehairy, Amany F.; Berton, Danilo Cortozi; Domnik, Nicolle J.; Neder, J. Alberto

doi:10.3389/fphys.2017.00082

Cited by 71 publications

(70 citation statements)

References 264 publications

(433 reference statements)

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“…Peak-VO 2 Kg is the gold standard for the evaluation of cardiopulmonary fitness, Max-VO 2 Kg is used to evaluate endurance, and AT-VO 2 Kg is used in the evaluation of aerobic exercise capacity. 21 The present study showed that exercise endurance evaluation indexes such as AT-VO 2 Kg, Max-VO 2 Kg, AT-O 2 puls, AT-Load, AT-Mets, and Max-Mets were improved after EECP therapy in the general population without cardiovascular diseases. This suggests that EECP can generally improve exercise endurance.…”

Section: Discussionsupporting

confidence: 51%

<p>Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial</p>

Zhao¹,

Huang²,

Lian³

et al. 2020

COPD

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These authors contributed equally to this workPurpose: Enhanced external counterpulsation (EECP) is popular in China for the treatment of coronary heart diseases, but it may be an effective treatment for other populations. This study aimed to explore the effect of EECP on exercise endurance of healthy people and chronic obstructive pulmonary disease (COPD) patients and provide intervention measures to improve their physical condition. Patients and methods: Patients were enrolled in this pilot randomized controlled trial at Jiangbin Hospital, China, between March 1st and May 30th, 2018. They were randomly divided into the EECP and non-EECP groups. According to their maximal oxygen uptake, the volunteers were also sub-grouped into the normal, low exercise endurance, and COPD subgroups. Differences in exercise endurance were evaluated between the EECP and non-EECP groups before and after treatment. Cardiopulmonary exercise testng included anaerobic threshold oxygen uptake (AT-VO 2 Kg), maximum oxygen uptake (Max-VO 2 Kg), anaerobic threshold pulse (AT-O 2 puls), anaerobic threshold metabolic equivalent (AT-Mets), and maximum metabolic equivalent (Max-Mets). Results: 72 volunteers were enrolled. The EECP and non-EECP groups were similar in terms of age, sex, body mass index, blood pressure, heart rate, breathing frequency, AT-VO 2 Kg, Max-VO 2 Kg, AT-O 2 puls, AT-Mets, and Max-Mets (P > 0.05) before treatment. EECP significantly improved AT-VO 2 Kg, Max-VO 2 Kg, AT-O 2 puls, AT-Mets, and Max-Mets compared with the non-EECP group (P<0.05). When analyzed according to sub-groups, the AT-VO 2 Kg, Max-VO 2 Kg, AT-O 2 puls, AT-Mets, and Max-Mets of the normal, low exercise endurance, and COPD subgroups were all significantly increased after EECP (P<0.05). Conclusion: EECP significantly improved the exercise endurance of normal adults, low endurance adults, and COPD patients. Registration number: ChiCTR1900021993.

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Section: Discussionsupporting

confidence: 51%

<p>Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial</p>

Zhao¹,

Huang²,

Lian³

et al. 2020

COPD

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“…A high level of V D EELV "buoyed" the expandable basic lung volume above its position, meaning that V T had limited room to expand downwards so that it could not help but invade upwards to the OT or near its limit (Figure 2). In COPD, decreased OT [3,22] and increased DH have been reported to be possible causes of exercise limitation [30], although some studies have questioned whether DH occurs in all COPD patients [31][32][33]. These previous studies have measured DH peak but not included V Dpeak .…”

Section: The % Of Tlcmentioning

confidence: 99%

“…Since DH may not occur in all COPD patients [31][32][33], as VDDHpeak% and VDEELVpeak% are substantially 310 larger and slightly more related to dyspnea [31] and exercise capacity than DH% and EELV%, and as VTpeak% 311…”

Section: Clinical Implications Of Vddhpeak% and Vdeelvpeak% And Vtpementioning

confidence: 99%

“…Since DH may not occur in all COPD patients [31][32][33], as V D DH peak % and V D EELV peak % are substantially larger and slightly more related to dyspnea [31] and exercise capacity than DH% and EELV%, and as V Tpeak % can be obtained easily and noninvasively, these three markers could potentially be used to evaluate the effect of bronchodilator or lung volume reduction surgery on dyspnea and exercise tolerance.…”

Section: Clinical Implications Of V D Dh Peak % and V D Eelv Peak % mentioning

confidence: 99%

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Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

Chuang

2020

JCM

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Physiological dead space volume (V D ) and dynamic hyperinflation (DH) are two different types of abnormal pulmonary physiology. Although they both involve lung volume, their combination has never been advocated, and thus their effect and implication are unclear. This study aimed (1) to combine V D and DH, and (2) investigate their relationship and clinical significance during exercise, as well as (3) identify a noninvasive variable to represent the V D fraction of tidal volume (V D /V T ). Forty-six male subjects with chronic obstructive pulmonary disease (COPD) and 34 healthy male subjects matched for age and height were enrolled. Demographic data, lung function, and maximal exercise were investigated. End-expiratory lung volume (EELV) was measured for the control group and estimated for the study group using the formulae reported in our previous study. The V D /V T ratio was measured for the study group, and reference values of V D /V T were used for the control group. In the COPD group, the DH peak /total lung capacity (TLC, DH peak %) was 7% and the EELV peak % was 70%. After adding the V Dpeak % (8%), the V D DH peak % was 15% and the V D EELV peak % was 78%. Both were higher than those of the healthy controls. In the COPD group, the V D DH peak % and V D EELV peak % were more correlated with dyspnea score and exercise capacity than that of the DH peak % and EELV%, and had a similar strength of correlation with minute ventilation. The V Tpeak /TLC (V Tpeak %), an inverse marker of DH, was inversely correlated with V D /V T (R 2 ≈ 0.50). Therefore, we recommend that V D should be added to DH and EELV, as they are physiologically meaningful and V Tpeak % represents not only DH but also dead space ventilation. To obtain V D , the V D /V T must be measured. Because obtaining V D /V T requires invasive arterial blood gases, further studies on noninvasive predicting V D /V T is warranted.

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“…Patients require significant less ventilation to perform the same level of exercise after exercise training. In turn, this reduction in the minute ventilation prevent, or at least improves, the potential development of dynamic hyperinflation 80 . Moreover, the reduction of lactate production results in improvement in muscle fatigue 77,78 .…”

Section: Aerobic and Combined (Aerobic And Resistance) Trainingmentioning

confidence: 99%

Physical Activity and Underlying Muscle Biology in Chronic Obstructive Pulmonary Disease (COPD)

Mantoani¹,

Silva²,

Rabinovich³

2021

BRN

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Muscle dysfunction is one of the most studied systemic effects in patients with chronic obstructive pulmonary disease (COPD) and a predictor of mortality. It can be caused by sedentary habit due to muscle underuse. Conversely, muscle dysfunction also contributes to inactivity in COPD. To date, the underlying mechanisms of muscle dysfunction and their impacts on physical activity (PA) levels in COPD were not explored in a literature review. The aims of this review are to summarise and discuss the link between muscle dysfunction and biology with reduced levels of daily PA in patients with COPD. This manuscript covers the many aspects of physical inactivity in COPD, the relationship between muscle dysfunction and muscle biology with physical inactivity in this population, as well as the strategies used to tackle muscle impairment with a possible positive impact on activity levels in COPD and other complementary strategies to increase PA in this population. (BRN Rev. 2019;5(3):215-29) Corresponding author: Roberto A Rabinovich, Roberto.Rabinovich@ed.ac.uk Key words: Chronic obstructive pulmonary disease. Muscle biology. Muscle dysfunction. Physical activity. BARCELONA RESPIRATORY NETWORK Collaborative research 216 BRN Rev. 2019;5(3) BARCELONA RESPIRATORY NETWORK Collaborative research 217 L. Cruz Mantoani, et al.: Physical Activity and Muscle biology in chronic Obstructive Pumonary Disease BARCELONA RESPIRATORY NETWORK Collaborative research 218 BRN Rev. 2019;5(3) capacity) 36 , capillarisation defects 37 , and altered mitochondrial function 38,39 .

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Advances in the Evaluation of Respiratory Pathophysiology during Exercise in Chronic Lung Diseases

Cited by 71 publications

References 264 publications

<p>Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial</p>

<p>Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial</p>

Combining Dynamic Hyperinflation with Dead Space Volume during Maximal Exercise in Patients with Chronic Obstructive Pulmonary Disease

Physical Activity and Underlying Muscle Biology in Chronic Obstructive Pulmonary Disease (COPD)

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