Role of inspiratory capacity on exercise tolerance in COPD patients with and without tidal expiratory flow limitation at rest
Open accessAbstract
Expiratory flow limitation promotes dynamic hyperinflation during exercise in chronic obstructive pulmonary disease (COPD) patients with a consequent reduction in inspiratory capacity (IC), limiting their exercise tolerance. Therefore, the exercise capacity of patients with tidal expiratory flow limitation (FL) at rest should depend on the magnitude of IC. The presented study was designed to evaluate the role of FL on the relationship between resting IC, other respiratory function variables and exercise performance in COPD patients. Fifty-two patients were included in the study. Negative expiratory pressure (NEP) uptake (VO2,max) were measured during an incremental symptom-limited cycle exercise. Twenty-nine patients were FL at rest. The IC was normal in all non-FL patients, while in most FL subjects it was decreased. Both WRmax and VO2,max were lower in FL patients (p<0.001, each). A close relationship of WRmax and O2,max to IC was found (r=0.73 and 0.75, respectively; p<0.0001, each). In the whole group, stepwise regression analysis selected IC and forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) (% predicted) as the only significant contributors to exercise tolerance. Subgroup analysis showed that IC was the sole predictor in FL patients, and FEV1/FVC in non-FL patients. Detection of flow limitation provides useful information on the factors that influence exercise capacity in chronic obstructive pulmonary disease patients. Accordingly, in patients with flow limitation, inspiratory capacity appears as the best predictor of exercise tolerance, reflecting the presence of dynamic hyperinflation.
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There is a significant correlation between resting IC and peak work rate and peak oxygen uptake, particularly in patients with demonstrable expiratory flow limitation at rest.
“Work from other groups supports these results by showing a significant correlation between resting IC and peak work rate and peak oxygen uptake, particularly in patients with demonstrable expiratory flow limitation at rest.88”
From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [88]
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- Authors
- Diaz, O., Villafranca, C., Ghezzo, H., Borzone, G., Leiva, A., Milic-Emil, J., & Lisboa, C.
- Affiliations
- Pontificia Universidad Católica de Chile (CL)
- McGill University (CA)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2000-08
- Volume
- 16
- Issue
- 2
- Pages
- 269
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2127159607
- Cited by
- 300
- References
- 27
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 6 · 2019: 11 · 2018: 8 · 2017: 11 · 2016: 6 · 2015: 13 · 2014: 10 · 2013: 12 · 2012: 19
- FWCI
- 7.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- chronic obstructive pulmonary disease, inspiratory capacity, exercise tolerance, dynamic hyperinflation, negative expiratory pressure, VO2max, FEV1, FEV1/FVC ratio
- MeSH terms
- Aged, Female, Forced Expiratory Volume, Forecasting, Humans, Inspiratory Capacity, Lung Diseases, Obstructive, Male, Oxygen Consumption, Physical Endurance, Pulmonary Ventilation, Rest, Tidal Volume, Vital Capacity, Exercise
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