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Asymptomatic subjects with airway obstruction have significant impairment at exercise.
- Source :
-
Thorax [Thorax] 2016 Sep; Vol. 71 (9), pp. 804-11. Date of Electronic Publication: 2016 May 25. - Publication Year :
- 2016
-
Abstract
- Background: The relevance of screening for airway obstruction in subjects not complaining of COPD symptoms may depend on the definition of airway obstruction. Response to exercise in asymptomatic subjects with persistent airway obstruction as defined by a postbronchodilator FEV1/FVC <5th centile lower limit of normal (LLN) remains unknown.<br />Methods: Dyspnoea (Borg scale), exercise tolerance and ventilatory constraints on tidal volume expansion were assessed in 20 consecutive asymptomatic subjects with persistent mild airway obstruction detected by screening (postbronchodilator FEV1/FVC z-score: -2.14±0.29; FEV1 z-score: -1.02±0.64) undergoing incremental cycle cardiopulmonary exercise testing, compared with 20 healthy controls with normal spirometry matched for age, sex, body mass index and smoking history (FEV1/FVC z-score: -0.13±0.57; FEV1 z-score: 0.32±0.67) and with 20 symptomatic patients with COPD matched for the same characteristics (FEV1/FVC z-score: -2.36±0.51; FEV1 z-score: -1.02±0.48).<br />Results: Asymptomatic subjects with airway obstruction had higher dyspnoea ratings than controls during incremental exercise. Asymptomatic subjects with airway obstruction had also peak oxygen consumption and peak power output that were lower than controls, and similar to those observed in patients with COPD. Although less frequent than in COPD, dynamic hyperinflation was more frequent in asymptomatic subjects with airway obstruction than in controls (85%, 50% and 10%, respectively; p=0.01 in asymptomatic subjects vs controls and p=0.04 vs COPD).<br />Conclusions: Although they did not present with chronic activity-related dyspnoea, subjects with a postbronchodilator FEV1/FVC<LLN as detected by screening had poorer exercise tolerance than healthy controls on exertion, and a significant proportion of them had dynamic hyperinflation. These subjects may, therefore, deserve further attention and may warrant regular follow-up.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Subjects :
- Adult
Aged
Bronchial Provocation Tests methods
Case-Control Studies
Dyspnea etiology
Dyspnea physiopathology
Exercise Test methods
Female
Forced Expiratory Volume physiology
Humans
Male
Mass Screening methods
Middle Aged
Oxygen Consumption physiology
Pulmonary Disease, Chronic Obstructive complications
Pulmonary Disease, Chronic Obstructive diagnosis
Spirometry methods
Tidal Volume physiology
Exercise Tolerance physiology
Pulmonary Disease, Chronic Obstructive physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-3296
- Volume :
- 71
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Thorax
- Publication Type :
- Academic Journal
- Accession number :
- 27226423
- Full Text :
- https://doi.org/10.1136/thoraxjnl-2015-207953