Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

Dynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary disease

Autor Takara, Luciana Shimizu Autor UNIFESP Google Scholar
Cunha, Thulio Marquez Autor UNIFESP Google Scholar
Barbosa, Priscila Boaventura Autor UNIFESP Google Scholar
Rodrigues, Miguel Koite Autor UNIFESP Google Scholar
Oliveira, Mayron Faria Autor UNIFESP Google Scholar
Nery, Luiz Eduardo Autor UNIFESP Google Scholar
Neder, Jose Alberto Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Queen’s University Department of Medicine Division of Respiratory and Critical Care Medicine
Resumo This study evaluated the dynamic behavior of total and compartmental chest wall volumes [(V CW) = rib cage (V RC) + abdomen (V AB)] as measured breath-by-breath by optoelectronic plethysmography during constant-load exercise in patients with stable chronic obstructive pulmonary disease. Thirty males (GOLD stages II-III) underwent a cardiopulmonary exercise test to the limit of tolerance (Tlim) at 75% of peak work rate on an electronically braked cycle ergometer. Exercise-induced dynamic hyperinflation was considered to be present when end-expiratory (EE) V CW increased in relation to resting values. There was a noticeable heterogeneity in the patterns of V CW regulation as EEV CW increased non-linearly in 17/30 hyperinflators and decreased in 13/30 non-hyperinflators (P < 0.05). EEV AB decreased slightly in 8 of the hyperinflators, thereby reducing and slowing the rate of increase in end-inspiratory (EI) V CW (P < 0.05). In contrast, decreases in EEV CW in the non-hyperinflators were due to the combination of stable EEV RC with marked reductions in EEV AB. These patients showed lower EIV CW and end-exercise dyspnea scores but longer Tlim than their counterparts (P < 0.05). Dyspnea increased and Tlim decreased non-linearly with a faster rate of increase in EIV CW regardless of the presence or absence of dynamic hyperinflation (P < 0.001). However, no significant between-group differences were observed in metabolic, pulmonary gas exchange and cardiovascular responses to exercise. Chest wall volumes are continuously regulated during exercise in order to postpone (or even avoid) their migration to higher operating volumes in patients with COPD, a dynamic process that is strongly dependent on the behavior of the abdominal compartment.
Palavra-chave Exertion
Lung mechanics
COPD
Dyspnea
Exercise test
Idioma Inglês
Financiador Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Data de publicação 2012-12-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 45, n. 12, p. 1276-1283, 2012.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 1276-1283
Fonte http://dx.doi.org/10.1590/S0100-879X2012001200024
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000312461700024
SciELO S0100-879X2012001200024 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/7481

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