Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults

Cory, Julia; Schaeffer, Michele R.; Wilkie, Sabrina S.; Ramsook, Andrew H.; Puyat, Joseph H.; Arbour, Brandon; Basran, Robbi; Lam, Michael Huen Sum; Les, Christian; MacDonald, Benjamin E.; Jensen, Dennis; Guenette, Jordan A.

doi:10.1152/japplphysiol.00520.2015

Cited by 53 publications

(57 citation statements)

References 48 publications

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“…The present findings are consistent with recent laboratory data that females have smaller absolute lung volumes and experience more dyspnoea for a given absolute work rate, ventilation or metabolic requirement during laboratory-based cardiopulmonary exercise testing in young and older subjects [15][16][17]27]. In addition to having smaller lungs, females have narrower airways than males, even when matched on lung size (dysanapsis) [12,28,29].…”

Section: Mechanismssupporting

confidence: 91%

Absolute values of lung function explain the sex difference in breathlessness in the general population

et al. 2017

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Activity-related breathlessness is twice as common among females as males in the general population and is associated with adverse health outcomes. We tested whether this sex difference is explained by the lower absolute forced expiratory volume in 1 s (FEV) or forced vital capacity (FVC) in females.This was a cross-sectional analysis of 3250 subjects (51% female) aged 38-67 years across 13 countries in the population-based third European Community Respiratory Health Survey. Activity-related breathlessness was measured using the modified Medical Research Council (mMRC) scale. Associations with mMRC were analysed using ordered logistic regression clustering on centre, adjusting for post-bronchodilator spirometry, body mass index, pack-years smoking, cardiopulmonary diseases, depression and level of exercise.Activity-related breathlessness (mMRC ≥1) was twice as common in females (27%) as in males (14%) (odds ratio (OR) 2.21, 95% CI 1.79-2.72). The sex difference was not reduced when controlling for FEV % predicted (OR 2.33), but disappeared when controlling for absolute FEV (OR 0.89, 95% CI 0.69-1.14). Absolute FEV explained 98-100% of the sex difference adjusting for confounders. The effect was similar within males and females, when using FVC instead of FEV and in healthy never-smokers.The markedly more severe activity-related breathlessness among females in the general population is explained by their smaller spirometric lung volumes.

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Section: Mechanismssupporting

confidence: 91%

Absolute values of lung function explain the sex difference in breathlessness in the general population

et al. 2017

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“…Finally, while sex differences in breathing patterns contribute to differences in oxygen consumption (probably in a discrete way, since VO 2 also depends on the cardiovascular and metabolic response), they may also impact sex differences in the development of dyspnea, the perception of breathing discomfort during intense exercise. The fact that women are more prone than males to report experiencing dyspnea (Cory et al, ) could be related to their greater reliance on thoracic rather than abdominal breathing.…”

Section: Discussionmentioning

confidence: 93%

Three‐dimensional analysis of sexual dimorphism in ribcage kinematics of modern humans

García‐Martínez

Bastir

Torres-Tamayo

et al. 2019

American J Phys Anthropol

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Objectives: Sexual dimorphism is an important biological factor underlying morphological variation in the human skeleton. Previous research found sex-related differences in the static ribcage, with males having more horizontally oriented ribs and a wider lower ribcage than females. Furthermore, a recent study found sex-related differences in the kinematics of the human lungs, with cranio-caudal movements of the caudal part of the lungs accounting for most of the differences between sexes. However, these movements cannot be quantified in the skeletal ribcage, so we do not know if the differences observed in the lungs are also reflected in sex differences in the motion of the skeletal thorax. Materials and methods:To address this issue, we quantified the morphological variation of 42 contemporary human ribcages (sex-balanced) in both maximal inspiration and expiration using 526 landmarks and semilandmarks. Thoracic centroid size differences between sexes were assessed using a t test, and shape differences were assessed using Procrustes shape coordinates, through mean comparisons and dummy regressions of shape on kinematic status. A principal components analysis was used to explore the full range of morphological variation.Results: Our results show significant size differences between males and females both in inspiration and expiration (p < .01) as well as significant shape differences, with males deforming more than females during inspiration, especially in the mediolateral dimension of the lower ribcage. Finally, dummy regressions of shape on kinematic status showed a small but statistically significant difference in vectors of breathing kinematics between males and females (14.78 ; p < .01).Discussion: We support that sex-related differences in skeletal ribcage kinematics are discernible, even when soft tissues are not analyzed. We hypothesize that this differential breathing pattern is primarily a result of more pronounced diaphragmatic breathing in males, which might relate to differences in body composition, metabolism, and ultimately greater oxygen demand in males compared to females. Future research should further explore the links between ribcage morphological variation and basal metabolic rate.

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“…; Cory et al . ), asthmatics (Chhabra & Chhabra, ) and individuals with chronic obstructive pulmonary disease (de Torres et al . ; ; Guenette et al .…”

Section: Discussionmentioning

confidence: 99%

Manipulation of mechanical ventilatory constraint during moderate intensity exercise does not influence dyspnoea in healthy older men and women

Molgat‐Seon

Ramsook

Peters

et al. 2019

The Journal of Physiology

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Key pointsr The perceived intensity of exertional breathlessness (i.e. dyspnoea) is higher in older women than in older men, possibly as a result of sex-differences in respiratory system morphology.r During exercise at a given absolute intensity or minute ventilation, older women have a greater degree of mechanical ventilatory constraint (i.e. work of breathing and expiratory flow limitation) than their male counterparts, which may lead to a greater perceived intensity of dyspnoea.r Using a single-blind randomized study design, we experimentally manipulated the magnitude of mechanical ventilatory constraint during moderate-intensity exercise at ventilatory threshold in healthy older men and women. We found that changes in the magnitude of mechanical ventilatory constraint within the physiological range had no effect on dyspnoea in healthy older adults.r When older men and women perform moderate intensity exercise, mechanical ventilatory constraint does not contribute significantly to the sensation of dyspnoea.Abstract We aimed to determine the effect of manipulating mechanical ventilatory constraint during submaximal exercise on dyspnoea in older men and women. Eighteen healthy subjects (aged 60-80 years; nine men and nine women) completed two days of testing. On day 1, subjects Yannick Molgat-Seon completed his PhD under the supervision of Dr A. William Sheel in the School of Kinesiology at the University of British Columbia in Vancouver, Canada. His doctoral thesis examined how sex-based differences in respiratory system morphology affect the integrative physiological and sensory responses to exercise in healthy adults across the lifespan. He is currently a postdoctoral fellow at the Centre for Heart Lung Innovation at St Paul's Hospital and in the Department of Physical Therapy at the University of British Columbia in Vancouver, working under the supervision of Dr Jordan A. Guenette. His current research focuses on studying the mechanisms of breathlessness and exercise limitation in patients with chronic lung disease. Y. Molgat-Seon and others J Physiol 597.5were assessed for pulmonary function and performed a maximal incremental cycle exercise test. On day 2, subjects performed three 6-min bouts of cycling at ventilatory threshold, in a single-blind randomized manner, while breathing: (i) normoxic helium-oxygen (HEL) to reduce the work of breathing (W b ) and alleviate expiratory flow limitation (EFL); (ii) through an inspiratory resistance (RES) of ß5 cmH 2 O L −1 s −1 to increase W b ; and (iii) ambient air as a control (CON). Oesophageal pressure, diaphragm electromyography, and sensory responses (category-ratio 10 Borg scale) were monitored throughout exercise. During the HEL condition, there was a significant decrease in W b (men: -21 ± 6%, women: -17 ± 10%) relative to CON (both P < 0.01). Moreover, if EFL was present during CON (four men and five women), it was alleviated during HEL. Conversely, during the RES condition, W b (men: 42 ± 19%, women: 50 ± 16%) significantly increased relative to CON (both...

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Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults

Cited by 53 publications

References 48 publications

Absolute values of lung function explain the sex difference in breathlessness in the general population

Absolute values of lung function explain the sex difference in breathlessness in the general population

Three‐dimensional analysis of sexual dimorphism in ribcage kinematics of modern humans

Manipulation of mechanical ventilatory constraint during moderate intensity exercise does not influence dyspnoea in healthy older men and women

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