Academic Journal
Contrasting dynamic and peak exercise inspiratory constraints: Implications for dyspnoea and exercise tolerance in chronic obstructive pulmonary disease.
| Τίτλος: | Contrasting dynamic and peak exercise inspiratory constraints: Implications for dyspnoea and exercise tolerance in chronic obstructive pulmonary disease. |
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| Συγγραφείς: | Dal Lago P; Programa de Pós-Graduação em Ciências da Reabilitação e Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada. Electronic address: pdallago@ufcspa.edu.br., Berton DC; Unidade de Fisiologia Pulmonar, Programa de Pós-Graduação em Ciências Pneumológicas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil., Hijleh A; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Cardoso JV; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., James M; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Smyth RM; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Coyle M; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Vincent S; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Elbehairy AF; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Domnik N; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., O'Donnell DE; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada., Neder JA; Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada. |
| Πηγή: | Respiratory physiology & neurobiology [Respir Physiol Neurobiol] 2026 Oct; Vol. 345, pp. 104632. Date of Electronic Publication: 2026 Jul 27. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 101140022 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-1519 (Electronic) Linking ISSN: 15699048 NLM ISO Abbreviation: Respir Physiol Neurobiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam ; New York : Elsevier Science, c2002- |
| Ιατρικοί όροι (MeSH): | Pulmonary Disease, Chronic Obstructive*/physiopathology , Pulmonary Disease, Chronic Obstructive*/complications , Dyspnea*/physiopathology , Dyspnea*/etiology , Exercise Tolerance*/physiology , Inspiratory Capacity*/physiology , Inhalation*/physiology , Exercise*/physiology, Humans ; Male ; Exercise Test ; Female ; Middle Aged ; Aged ; Respiratory Function Tests |
| Περίληψη: | Background: Exertional dyspnoea is linked to inspiratory constraints to tidal volume expansion in chronic obstructive pulmonary disease (COPD). Dynamic assessment of these constraints via serial inspiratory capacity (IC) maneuvers across incremental cardiopulmonary exercise testing (CPET) might provide information regarding dyspnoea severity and exercise intolerance beyond the conventional peak IC-only approach. Methods: Pulmonary function tests and cycle ergometer CPET in 360 patients with COPD of varied severity. In addition to using peak-exercise cutoffs for critically high inspiratory constraints (CIC), a novel AI-based algorithm quantified dyspnoea and dynamic inspiratory constraints throughout progressively higher exercise intensities. Results: Among the CIC variables, end-inspiratory lung volume (EILV)/total lung capacity (TLC) ≥ 0.9 correlated best with dyspnoea and exercise intolerance. CIC and dynamic constraints (≤ 25th centile relative to sex- and age-adjusted norms) disagreed significantly: whereas ∼ a third of patients without CIC exhibited inspiratory constraints, ∼ a fifth of those with CIC did not (P < 0.05). Dynamic constraints, regardless of CIC, were significantly associated with abnormalities in submaximal mechanical-ventilatory responses, higher operating lung volumes, higher dyspnoea scores, and lower exercise tolerance. Of note, the prevalence of "high" dyspnoea-work rate and -ventilation (≥ 75% centile) was more than fourfold higher in patients with dynamic constraints, regardless of CIC (P < 0.05). Conclusions: Clinicians interested in assessing the presence and severity of dyspnoea attributable to ventilatory responses to exercise should consider serial IC measurements in patients with COPD. Novel AI-based approaches to quantify these dynamic abnormalities are poised to increase the sensitivity of this analytical approach. (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors have no conflicts of interest. |
| Contributed Indexing: | Keywords: Cardiopulmonary Exercise Testing; Gas Exchange; Inspiratory Capacity; Lung Mechanics; Pulmonary Function Tests; Ventilatory Efficiency |
| Entry Date(s): | Date Created: 20260727 Date Completed: 20260904 Latest Revision: 20260904 |
| Update Code: | 20260905 |
| DOI: | 10.1016/j.resp.2026.104632 |
| PMID: | 42508518 |
| Βάση Δεδομένων: | MEDLINE |
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