Physiological and clinical relevance of exercise ventilatory efficiency in COPD

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dc.citation.issue3
dc.citation.volume49
dc.contributor.authorNeder, J. Alberto
dc.contributor.authorBerton, Danilo C.
dc.contributor.authorArbex, Flavio F. [UNIFESP]
dc.contributor.authorAlencar, Maria Clara
dc.contributor.authorRocha, Alcides [UNIFESP]
dc.contributor.authorSperandio, Priscila A. [UNIFESP]
dc.contributor.authorPalange, Paolo
dc.contributor.authorO'Donnell, Denis E.
dc.coverageSheffield
dc.date.accessioned2020-07-17T14:02:49Z
dc.date.available2020-07-17T14:02:49Z
dc.date.issued2017
dc.description.abstractExercise ventilation (V'E) relative to carbon dioxide output (V'CO2) is particularly relevant to patients limited by the respiratory system, e.g. those with chronic obstructive pulmonary disease ( COPD). High V'E- V'CO2 ( poor ventilatory efficiency) has been found to be a key physiological abnormality in symptomatic patients with largely preserved forced expiratory volume in 1 s ( FEV1). Establishing an association between high V'E- V'CO2 and exertional dyspnoea in mild COPD provides evidence that exercise intolerance is not a mere consequence of detraining. As the disease evolves, poor ventilatory efficiency might help explaining "out- of- proportion" breathlessness ( to FEV1 impairment). Regardless, disease severity, cardiocirculatory co-morbidities such as heart failure and pulmonary hypertension have been found to increase V'E- V'CO2. In fact, a high V'E- V'CO2 has been found to be a powerful predictor of poor outcome in lung resection surgery. Moreover, a high V'E- V'CO2 has added value to resting lung hyperinflation in predicting all-cause and respiratory mortality across the spectrum of COPD severity. Documenting improved ventilatory efficiency after lung transplantation and lung volume reduction surgery provides objective evidence of treatment efficacy. Considering the usefulness of exercise ventilatory efficiency in different clinical scenarios, the V'E- V'CO2 relationship should be valued in the interpretation of cardiopulmonary exercise tests in patients with mild-to-end-stage COPD.en
dc.description.affiliationQueens Univ, Resp Invest Unit, Kingston, ON, Canada
dc.description.affiliationQueens Univ, Lab Clin Exercise Physiol, Kingston, ON, Canada
dc.description.affiliationKingston Gen Hosp, Kingston, ON, Canada
dc.description.affiliationUniv Fed Rio Grande do Sul, Div Resp Med, Porto Alegre, RS, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Div Resp, Pulm Funct & Clin Exercise Physiol, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Minas Gerais, Div Cardiol, Belo Horizonte, MG, Brazil
dc.description.affiliationSapienza Univ Rome, Dept Publ Hlth & Infect Dis, Rome, Italy
dc.description.affiliationUnifespUniv Fed Sao Paulo, Div Resp, Pulm Funct & Clin Exercise Physiol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNew Clinician Scientist Program from the Southeastern Ontario Academic Medical Association (SEAMO), Canada
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1183/13993003.02036-2016
dc.identifier.citationEuropean Respiratory Journal. Sheffield, v. 49, n. 3, p. -, 2017.
dc.identifier.doi10.1183/13993003.02036-2016
dc.identifier.issn0903-1936
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55047
dc.identifier.wosWOS:000397931500032
dc.language.isoeng
dc.publisherEuropean Respiratory Soc Journals Ltd
dc.relation.ispartofEuropean Respiratory Journal
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titlePhysiological and clinical relevance of exercise ventilatory efficiency in COPDen
dc.typeinfo:eu-repo/semantics/article
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