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Inhaled Bronchodilators Reduce Dynamic Hyperinflation During Exercise in Patients With Chronic Obstructive Pulmonary Disease
Abstract
Dynamic hyperinflation (DH) is a major pathophysiologic consequence of airflow limitation during exercise in patients with chronic obstructive pulmonary disease (COPD) and an important contributing factor to breathlessness. In this study we aimed to examine the effect of inhaled beta agonist therapy on DH during exercise in these patients and the relationship between changes in DH and breathlessness. In 13 COPD patients (mean age 65.1 +/- 2.0, FEV1 1.20 +/- 0.17, FEV1/FVC 40 +/- 3) we measured pulmonary function tests, exercise breathlessness by Borg score, and exercise flow volume and pressure volume loops on two separate days. Prior to testing, patients randomly received inhaled placebo or albuterol on the first test day and the alternative medication on the second test day. From measurements of exercise inspiratory capacity (IC), we calculated the end-expiratory and end-inspiratory lung volumes (EELV, EILV). We used esophageal pressure recordings to measure peak inspiratory esophageal pressure (Pesins) during exercise and this was related to the maximal capacity for pressure generation taking into account lung volume and airflow changes (Pcapi). Bronchodilator caused significant increase in both FEV1 and FVC (+0.23 and +0.51, p<0.01). Comparisons of breathlessness, exercise volumes, and pressures were made at the highest equivalent work load. There was a significant reduction in the peak exercise EELV/TLC (80 +/- 0.02% to 76 +/- 0.02%, p<0.05) while the peak EILV/TLC decreased by 2% (97 +/- 1% to 95 +/- 1%, p<0.05). The peak Pesins/Pcapi decreased (0.79 +/- 0.10 to 0.57 +/- 0.05, p<0.05), and the Pcapi - Pesins increased (7.4 +/- 3 to 13.0 +/- 3 cm H2O, p<0.05). There was significant improvement in neuroventilatory coupling for volume change (Pesins/Pcapi/VT/TLC 5.45 +/- 0.5 to 3.25 +/- 1.0, p<0.05). There was a significant reduction in breathlessness as measured by Borg score (4.5 +/- 0.7 to 3.1 +/- 0.5, p<0.05) and there was a significant correlation between delta Borg and delta EILV/TLC (r=0.771, p<0.01) with a trend for Pesins/Pcapi/VT/TLC (r=0.544, p=0.067). There was also a significant correlation between delta EELV/TLC and delta Pesins/Pcapi/VT/TLC (r=0.772, p<0.01). The relationships between delta Borg, delta resting volumes, and flow rates were not significant. We conclude that in patients with COPD, inhaled bronchodilator reduces exercise DH and improves inspiratory pressure reserve and neuroventilatory coupling. Changes in DH and neuroventilatory coupling were the main determinants of reduced breathlessness.
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“Moreover, interventions that deflate the lungs (ie, reduce EILV and EELV) and delay the onset of critical VT constraints consistently reduce dyspnea intensity in patients with COPD during exercise.45,46,55,56”
From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [55]
In the citing paper
“Pharmacological interventions that reduce operating lung volumes and delay the onset of ventilatory limitation consistently reduce the intensity of dyspnea during exercise in patients with COPD.46,55,56”
From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [55]
Citations
Cites
Psychophysical bases of perceived exertion
BORG, G. A. V. (1982) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198205000-00012 · Cited by 16,580
Standardization of Spirometry — 1987 Update
Buist, A. S. (1987) · American Review of Respiratory Disease · doi:10.1164/ajrccm/136.5.1073 · Cited by 3,256
O'Donnell, D. E., & Webb, K. A. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/148.5.1351 · Cited by 543
The n-of-1 Randomized Controlled Trial: Clinical Usefulness
Guyatt, G., Keller, J. L., Jaeschke, R., Rosenbloom, D., Adachi, J. D., & Newhouse, M. T. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-112-4-293 · Cited by 320
Pulmonary mechanics during exercise in subjects with chronic airflow obstruction
Stubbing, D. G., Pengelly, L. D., Morse, J. L., & Jones, N. L. (1980) · Journal of Applied Physiology · doi:10.1152/jappl.1980.49.3.511 · Cited by 314
Potter, W. A., Ólafsson, S., & Hyatt, R. E. (1971) · Journal of Clinical Investigation · doi:10.1172/jci106563 · Cited by 241
Murciano, D., Auclair, M.-H., Parienté, R., & Aubier, M. (1989) · New England Journal of Medicine · doi:10.1056/nejm198906083202304 · Cited by 223
Chest wall mechanics during exercise in patients with severe chronic air-flow obstruction.
Dodd, D., Brancatisano, T. P., & Engel, L. A. (1984) · PubMed · doi:10.1164/arrd.1984.129.1.33 · Cited by 195
Effect of mild-to-moderate airflow limitation on exercise capacity
Babb, T. G., Viggiano, R. W., Hurley, B. F., Staats, B., & RODARTE, J. R. (1991) · Journal of Applied Physiology · doi:10.1152/jappl.1991.70.1.223 · Cited by 195
Dose response relation to oral theophylline in severe chronic obstructive airways disease.
Chrystyn, H., Mulley, B. A., & Peake, M. D. (1988) · BMJ · doi:10.1136/bmj.297.6662.1506 · Cited by 164
Breathlessness and exercise in patients with cardiorespiratory disease.
Jj, B., & Wr, C. (1986) · PubMed · Cited by 153
Breathlessness during Acute Bronchoconstriction in Asthma: Pathophysiologic Mechanisms
Lougheed, M. D., Lam, M., Forkert, L., Webb, K. A., & O’Donnell, D. E. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/148.6_pt_1.1452 · Cited by 149
Effect of CPAP on respiratory effort and dyspnea during exercise in severe COPD
Petrof, B. J., Calderini, E., & Gottfried, S. B. (1990) · Journal of Applied Physiology · doi:10.1152/jappl.1990.69.1.179 · Cited by 131
Breathlessness in Patients with Chronic Airflow Limitation
O’Donnell, D. E. (1994) · CHEST Journal · doi:10.1378/chest.106.3.904 · Cited by 114
O’Donnell, D. E., Sanii, R., Giesbrecht, G. G., & Younes, M. (1988) · American Review of Respiratory Disease · doi:10.1164/ajrccm/138.5.1185 · Cited by 113
Determination of Bronchodilation in the Clinical Pulmonary Function Laboratory
Ramsdell, J., & Tisi, G. M. (1979) · CHEST Journal · doi:10.1378/chest.76.6.622 · Cited by 57
Aminophylline and the Respiratory Muscles: An Alternative View
Moxham, J. (1988) · Clinics in Chest Medicine · doi:10.1016/s0272-5231(21)00508-6 · Cited by 44
Jenne, J. W., Siever, J., Druz, W. S., Solano, J. V., Cohen, S., & Sharp, J. T. (1984) · PubMed · doi:10.1164/arrd.1984.130.4.600 · Cited by 28
The effects of beta 2-agonists and caffeine on respiratory and limb muscle performance.
Lanigan, C., Howes, T. Q., Borzone, G. R., Vianna, L. G., & Moxham, J. (1993) · PubMed · Cited by 19
Predicting Response to Bronchodilator Therapy in Chronic Obstructive Pulmonary Disease
Pratter, M. R. (1988) · Archives of Internal Medicine · doi:10.1001/archinte.148.9.1909 · Cited by 14
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Celli, B. R., MacNee, W., Agustí, A. G. N., Anzueto, A. R., Berg, B., Buist, A. S., Calverley, P. M., Chavannes, N. H., Dillard, T. A., Fahy, B. F., et al. (2004) · European Respiratory Journal · doi:10.1183/09031936.04.00014304 · Cited by 4,405
ATS/ACCP statement on cardiopulmonary exercise testing
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ATS/ACCP statement on cardiopulmonary exercise testing.
Ross, R. M. (2003) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.167.10.950 · Cited by 2,563
American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation
Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., Carone, M., Celli, B., Engelen, M., Fahy, B., et al. (2006) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200508-1211st · Cited by 1,966
Metadata
- Authors
- Belman, M. J., Botnick, W. C., & Shin, J. W.
- Affiliations
- Cedars-Sinai Medical Center (US)
- ORCID
- Shin, J W
- Venue
- American journal of respiratory and critical care medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-03-01
- Volume
- 153
- Issue
- 3
- Pages
- 967-975
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2007810665
- Cited by
- 402
- References
- 21
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 1 · 2020: 8 · 2019: 5 · 2018: 1 · 2017: 4 · 2016: 9 · 2015: 6 · 2014: 8 · 2013: 10 · 2012: 10
- FWCI
- 11.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Keywords
- dynamic hyperinflation, chronic obstructive pulmonary disease, inhaled beta-agonists, salbutamol, esophageal pressure, end-expiratory lung volume, inspiratory capacity, pressure-volume loops, inspiratory muscle strength, inspiratory muscle endurance, inspiratory muscle training
- MeSH terms
- Administration, Inhalation, Adrenergic beta-Agonists, Aged, Albuterol, Bronchodilator Agents, Dyspnea, Esophagus, Physical Exertion, Female, Forced Expiratory Volume, Humans, Inspiratory Capacity, Lung, Lung Diseases, Obstructive, Male, Middle Aged, Peak Expiratory Flow Rate, Pressure, Pulmonary Ventilation, Total Lung Capacity, Vital Capacity, Respiratory Mechanics
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