Dynamic hyperinflation during treadmill exercise testing in patients with moderate to severe COPD

被引:9
作者
Cordoni, Priscila Kessar [1 ]
Berton, Danilo Cortozi [2 ]
Squassoni, Selma Denis [1 ]
Aquino Scuarcialupi, Maria Enedina [3 ]
Neder, Jose Alberto [1 ,4 ]
Fiss, Elie [1 ]
机构
[1] ABC, Fac Med, Disciplina Pneumol, Santo Andre, SP, Brazil
[2] Federacao Estabelecimentos Ensino Super Novo Hamb, Inst Ciencias Saude, Novo Hamburgo, RS, Brazil
[3] Fac Med & Ciencias Med Paraiba, Joao Pessoa, Paraiba, Brazil
[4] Univ Fed Sao Paulo, Diseiplina Pneumol, Dept Med, Sao Paulo, Brazil
关键词
Pulmonary disease; chronic obstructive; Exercise; Exercise test; Inspiratory capacity; EXPIRATORY FLOW LIMITATION; MAXIMAL RESPIRATORY PRESSURES; MAJOR LIMITATION; CHEST-WALL; PERFORMANCE; WALKING; TOLERANCE; RESPONSES; SYMPTOMS; FATIGUE;
D O I
10.1590/S1806-37132012000100004
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
100201 [内科学];
摘要
Objective: To characterize the presence, extent, and patterns of dynamic hyperinflation (DH) during treadmill exercise testing in patients with moderate to severe COPD. Methods: This was a cross-sectional study involving 30 non-hypoxemic patients (FEV1 = 43 +/- 14% of predicted) who were submitted to a cardiopulmonary exercise test on a treadmill at a constant speed (70-80% of maximum speed) to the tolerance limit (Tlim). Serial inspiratory capacity (1C) maneuvers were used in order to assess DH. Results: Of the 30 patients studied, 19 (63.3%) presented with OH (DH+ group), having greater pulmonary function impairment at rest than did those without UN (OH group). None of the variables studied correlated with exercise tolerance in the DH- group, whereas Tlim, 1C, and perception of dyspnea during exercise did so correlate in the DH+ group (p < 0.05). In the DH+ group, 7 and 12 patients, respectively, presented with a progressive and a stable pattern of DH (Delta 1C(Tlim,2min)= -0.28 +/- 0.11 L vs. 0.04 +/- 0.10 L; p <0.01). Patients with a progressive pattern of DH presented with higher perception of dyspnea/Tlim rate and lower exercise tolerance than did those with a stable pattern (354 +/- 118 s and 465 +/- 178 s, respectively; p < 0.05). Conclusions: The presence of DH is not a universal phenomenon during walking in COPD patients, even in those with moderate to severe airflow limitation. In the patients who presented DH, a progressive pattern of DH had a greater impact on exercise tolerance than did a stable pattern of DH.
引用
收藏
页码:13 / 23
页数:11
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