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

dc.contributor.authorTakara, Luciana Shimizu [UNIFESP]
dc.contributor.authorCunha, Thulio Marquez [UNIFESP]
dc.contributor.authorBarbosa, Priscila Boaventura [UNIFESP]
dc.contributor.authorRodrigues, Miguel Koite [UNIFESP]
dc.contributor.authorOliveira, Mayron Faria [UNIFESP]
dc.contributor.authorNery, Luiz Eduardo [UNIFESP]
dc.contributor.authorNeder, Jose Alberto [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionQueen’s University Department of Medicine Division of Respiratory and Critical Care Medicine
dc.date.accessioned2015-06-14T13:45:07Z
dc.date.available2015-06-14T13:45:07Z
dc.date.issued2012-12-01
dc.description.abstractThis 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.en
dc.description.affiliationUniversidade Federal de São Paulo (UNIFESP) Departamento de Medicina Disciplina de Pneumologia
dc.description.affiliationQueen&#8217;s University Department of Medicine Division of Respiratory and Critical Care Medicine
dc.description.affiliationUnifespUNIFESP, Depto. de Medicina Disciplina de Pneumologia
dc.description.sourceSciELO
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.format.extent1276-1283
dc.identifierhttp://dx.doi.org/10.1590/S0100-879X2012001200024
dc.identifier.citationBrazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 45, n. 12, p. 1276-1283, 2012.
dc.identifier.doi10.1590/S0100-879X2012001200024
dc.identifier.fileS0100-879X2012001200024.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2012001200024
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/7481
dc.identifier.wosWOS:000312461700024
dc.language.isoeng
dc.publisherAssociação Brasileira de Divulgação Científica
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsAcesso aberto
dc.subjectExertionen
dc.subjectLung mechanicsen
dc.subjectCOPDen
dc.subjectDyspneaen
dc.subjectExercise testen
dc.titleDynamics of chest wall volume regulation during constant work rate exercise in patients with chronic obstructive pulmonary diseaseen
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