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Cited by 62Chronic Obstructive Pulmonary Disease (COPD) ResearchCardiovascular and exercise physiologyRespiratory Support and Mechanisms

Dynamic hyperinflation is associated with a poor cardiovascular response to exercise in COPD patients

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Tzani, Panagiota, Aiello, Marina, Elia, Davide, Boracchia, Luca, Marangio, Emilio, Olivieri, Dario, Clini, Enrico, Chetta, Alfredo·2011·Respiratory Research
DOI 10.1186/1465-9921-12-150PMC PMC3225311
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Abstract

BACKGROUND: Pulmonary hyperinflation has the potential for significant adverse effects on cardiovascular function in COPD. The aim of this study was to investigate the relationship between dynamic hyperinflation and cardiovascular response to maximal exercise in COPD patients. METHODS: We studied 48 patients (16F; age 68 yrs ± 8; BMI 26 ± 4) with COPD. All patients performed spirometry, plethysmography, lung diffusion capacity for carbon monoxide (TLco) measurement, and symptom-limited cardiopulmonary exercise test (CPET). The end-expiratory lung volume (EELV) was evaluated during the CPET. Cardiovascular response was assessed by change during exercise in oxygen pulse (ΔO2Pulse) and double product, i.e. the product of systolic blood pressure and heart rate (DP reserve), and by the oxygen uptake efficiency slope (OUES), i.e. the relation between oxygen uptake and ventilation. RESULTS: Patients with a peak exercise EELV (%TLC) ≥ 75% had a significantly lower resting FEV1/VC, FEF50/FIF50 ratio and IC/TLC ratio, when compared to patients with a peak exercise EELV (%TLC) < 75%. Dynamic hyperinflation was strictly associated to a poor cardiovascular response to exercise: EELV (%TLC) showed a negative correlation with ΔO2Pulse (r = - 0.476, p = 0.001), OUES (r = - 0.452, p = 0.001) and DP reserve (r = - 0.425, p = 0.004). Furthermore, according to the ROC curve method, ΔO2Pulse and DP reserve cut-off points which maximized sensitivity and specificity, with respect to a EELV (% TLC) value ≥ 75% as a threshold value, were ≤ 5.5 mL/bpm (0.640 sensitivity and 0.696 specificity) and ≤ 10,000 Hg · bpm (0.720 sensitivity and 0.783 specificity), respectively. CONCLUSION: The present study shows that COPD patients with dynamic hyperinflation have a poor cardiovascular response to exercise. This finding supports the view that in COPD patients, dynamic hyperinflation may affect exercise performance not only by affecting ventilation, but also cardiac function.

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  • During exercise, hyperinflation may impede cardiac function in COPD.

    “During exercise, hyperinflation may impede cardiac19,20 and respiratory muscle function and increase the work of breathing.21”

    From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [20]

  • Collectively, cardiovascular consequences of lung hyperinflation likely contribute, in highly variable combinations, to the reduced cardiac performance observed in some COPD patients during exercise.

    “Collectively, these cardiovascular consequences of lung hyperinflation likely contribute, in highly variable combinations, to the reduced cardiac performance observed in some COPD patients during exercise.20,85”

    From Pathogenesis of hyperinflation in chronic obstructive pulmonary disease (2014) · cites this paper as [20]

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Research works printed but not linked: 31

  1. O'Donnell DE Dynamic hyperinflation and its clinical implication in COPD Rev Mal Respir 2008 25 1305 18 10.1016/S0761-8425(08)75094-0 19107020 · DOI
  2. O'Donnell DE Hyperinflation, dyspnea, and exercise intolerance in chronic obstructive pulmonary disease Proc Am Thorac Soc 2006 3 180 84 10.1513/pats.200508-093DO 16565429 · DOI · Paper page
  3. Jörgesen K Müller MF Nel J Upton RN Houltz E Ricksten SE Reduced intrathoracic blood volume and left and right ventricular dimensions in patients with severe emphysema Chest 2007 131 1050 57 10.1378/chest.06-2245 17426209 · DOI
  4. Barr GR Bluemke DA Ahmed FS Carr JJ Enright PL Hoffman EA Jiang R Kawut SM Kronmal RA Lima JA Shahar E Smith LJ Watsom KE Percent emphysema, airflow obstruction, and impaired left ventricular filling N Engl J Med 2010 362 217 27 10.1056/NEJMoa0808836 20089972 PMC2887729 · DOI
  5. Vassaux C Torre-Bouscoulet L Zeineldine S Cortopassi F Paz-Diaz H Celli BR Pinto-Plata VM Effects of hypeinflation on the oxygen pulse as a marker of cardiac performance in COPD Eur Respir J 2008 32 1275 82 10.1183/09031936.00151707 18550609 · DOI · Paper page
  6. Task Force of the Italian Working Group on Cardiac Rehabilitation Prevention; Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology Piepoli MF Corrà U Agostoni PG Belardinelli R Cohen-Solal A Hambrecht R Vanhees L Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation. Part I: definition of cardiopulmonary exercise testing parameters for appropriate use in chronic heart failure Eur J Cardiovasc Prev Rehabil 2006 13 150 64 16575267
  7. Le V-V Mitiku T Sungar G Myers J Froelicher V The blood pressure response to dynamic exercise testing: a systematic review Prog Cardiovasc Dis 2008 5 135 60 18774013
  8. Baba R Nagashima M Goto M Nagano Y Yokota M Tauchi N Nishibata K Oxygen uptake efficiency slope: a new index of cardiorespiratory functional reserve derived from the relation between oxygen uptake and minute ventilation during incremental exercise J Am Coll Cardiol 1996 28 1567 72 10.1016/S0735-1097(96)00412-3 8917273 · DOI
  9. Pauwels RA Buist AS Calverley PM Jenkins GOLD Scientific Committee Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary Am J Respir Crit Care Med 2001 163 1256 76 11316667
  10. Miller MR Hankinson J Brusasco V Burgos F Casaburi R Coates A Crapo R Enright P van der Grinten CP Gustafsson P Jensen R Johnson DC MacIntyre N McKay R Navajas D Pedersen OF Pellegrino R Viegi G Wanger J ATS/ERS Task Force Standardisation of spirometry Eur Respir J 2005 26 319 38 10.1183/09031936.05.00034805 16055882 · DOI · Paper page
  11. Wanger J Clausen JL Coates A Pedersen OF Brusasco V Burgos F Casaburi R Crapo R Enright P van der Grinten CP Gustafsson P Hankinson J Jensen R Johnson D Macintyre N McKay R Miller MR Navajas D Pellegrino R Viegi G Standardisation of the measurement of lung volumes Eur Respir J 2005 26 511 22 10.1183/09031936.05.00035005 16135736 · DOI · Paper page
  12. Macintyre N Crapo RO Viegi G Johnson DC van der Grinten CP Brusasco V Burgos F Casaburi R Coates A Enright P Gustafsson P Hankinson J Jensen R McKay R Miller MR Navajas D Pedersen OF Pellegrino R Wanger J Standardisation of the single-breath determination of carbon monoxide uptake in the lung Eur Respir J 2005 6 720 35 16204605
  13. Quanjer PH Tammeling GJ Cotes JE Pedersen OF Peslin R Yernault JC Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society Eur Respir J Suppl 1993 6 5 40 8499054
  14. Cotes JE Chinn DJ Quanjer PH Roca J Yernault JC Standardization of the measurement of transfer factor (diffusing capacity). Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society Eur Respir J Suppl 1993 6 41 52 8499053
  15. ATS/ACCP Statement on Cardiopulmonary Exercise Testing Am J Respir Crit Care Med 2003 167 211 277 12524257
  16. Wasserman K Hansen JE Sue DY Normal values Principles of Exercise Testing & Interpretation 1994 Lippincott Williams & Wilkins. Philadelphia US 143 16221803233
  17. Stubbing DG Pengelly LD Morse JL Jones NL Pulmonary mechanics during exercise in subjects with chronic airflow obstruction J Appl Physiol 1980 49 511 515 7204175
  18. Tzani P Piepoli MF Longo F Aiello M Serra W Maurizio AR Olivieri D Chetta A Resting lung function in the assesment of the exercise capacity in patients with chronic heart failure Am J Med Sci 2010 339 210 215 10.1097/MAJ.0b013e3181c78540 20220330 · DOI
  19. Zweig MH Campell G Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine Clin Chem 1993 39 561 77 8472349
  20. O'Donnell DE Revill SM Webb KA Dynamic Hyperinflation and exercise intolerance in chronic obstructive pulmonary disease Am J Respir Crit Care Med 2001 164 770 77 11549531
  21. Cerveri I Dore R Corsico A Zoia MC Pellegrino R Brusasco V Pozzi E Assessment of emphysema in COPD. A functional and radiologic study Chest 2004 125 1714 18 10.1378/chest.125.5.1714 15136381 · DOI
  22. Puente-Maestu L Garcia de Pedro J Martinez-Abad Y Ruíz de Oña JM Llorente D Cubillo JM Dyspnea, ventilatory pattern, and changes in dynamic hyperinflation related to the intensity of constant work rate exercise in COPD Chest 2005 128 651 56 10.1378/chest.128.2.651 16100150 · DOI
  23. Watz H Waschki B Meyer T Kretshmar G Kirsten A Claussen M Magnussen H Decreasing Cardiac Chamber Sizes and Associated Heart Dysfunction in COPD. Role of Hyperinflation Chest 2010 138 1 32 38 20190002
  24. Butler J Schrijen F Henriquez A Pow JM Albert RK Cause of the Raised Wedge Pressure on Exercise in Chronic Obstructive Pulmonary Disease Am Rev Respir Dis 1988 138 350 354 3195834
  25. Watz H Waschki B Boehme C Claussen M Meyer T Magnussen H Extrapulmonary effects of chronic obstructive pulmonary disease on physical activity Am J Respir Crit Care Med 2008 177 743 751 10.1164/rccm.200707-1011OC 18048807 · DOI
  26. Whipp BJ Higgenbotham MB Cobb FC Estimating exercise stroke volume from asymptotic oxygen pulse in humans J Appl Physiol 1996 81 2674 2679 9018521
  27. Sala E Roca J Marrades RM Gonzalez De Suso JM Moreno A Barberá JA Nadal J de Jover L Rodriguez-Roisin R Wagner PD Effects of endurance training on skeletal muscle bioenergetics in chronic obstructive pulmonary disease Am J Respir Crit Care Med 1999 159 1726 1734 10351910
  28. Oelberg DA Kacmarek RM Pappagianopoulos PP Ginns LC Systrom DM Ventilatory and cardiovascular responses to inspired He-O2 during exercise in chronic obstructive pulmonary disease Am J Respir Crit Care Med 1998 158 1876 1882 9847281
  29. Montes de Oca M Rassulo J Celli BE Respiratory muscle and cardiopulmonary function during exercise in very severe COPD Am J Respir Crit Care Med 1996 154 1284 89 8912737
  30. Nelson RR Gobel FL Jorgensen CR Wang K Wang Y Taylor HL Hemodynamic predictors of myocardial oxygen consumption during static and dynamic exercise Circulaion 1974 50 1179 1189 4430113
  31. Hollenberg M Tager IB Oxygen uptake efficiency slope: an index of exercise performance and cardiopulmonary reserve requiring only submaximal exercise J AM Coll Cardiol 2000 36 194 201 10.1016/S0735-1097(00)00691-4 10898434 · DOI

Cited by

Sorted by citations

  • Pathogenesis of hyperinflation in chronic obstructive pulmonary disease

    Saey, Gagnon, P., Guenette, J., Langer, D., Laviolette, L., Mainguy, V., Maltais, F., & Ribeiro, F. (2014) · International Journal of Chronic Obstructive Pulmonary Disease · doi:10.2147/copd.s38934 · Cited by 180 · see citing works

    “contribute, in highly variable combinations, to the reduced cardiac performance observed in some COPD patients during exercise.(20,85) However, it should be acknowledged that not all studies have been able to demonstrate a direct link between dynamic hyperinflation and cardiac performance during exercise.”

Authors
Tzani, P., Aiello, M., Elia, D., Boracchia, L., Marangio, E., Olivieri, D., Clini, E., & Chetta, A.
Affiliations
  • Ospedale di Parma (IT)
  • University of Modena and Reggio Emilia (IT)
Corresponding author
Tzani, Panagiota
ORCID
Venue
Respiratory Research
Publisher
Springer Science and Business Media LLC
Published
2011-12
Volume
12
Issue
1
Pages
150-150
ISSN
  • 1465-9921 (ISSN-L)
  • 1465-993X
DOI
10.1186/1465-9921-12-150
PMC
PMC3225311
OpenAlex
W2161722005
Cited by
62
References
1
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 2 · 2020: 5 · 2018: 5 · 2017: 2 · 2016: 5 · 2015: 8 · 2014: 6 · 2013: 7 · 2012: 6
FWCI
5.18
Type
journal article
Language
en
Open access
Licence
Locations
  • Respiratory Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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, dynamic hyperinflation, end-expiratory lung volume, cardiovascular response to exercise, oxygen pulse, rate-pressure product, oxygen uptake efficiency slope, cardiopulmonary exercise testing, exercise capacity, cardiac function
MeSH terms
Adult, Aged, Aged, 80 and over, Blood Pressure, Bronchospirometry, Exercise Test, Female, Heart Rate, Humans, Male, Middle Aged, Plethysmography, Pulmonary Diffusing Capacity, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive

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