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      Lung mechanical constraints: the Achilles’ heel of excess exertional ventilation for prognosis assessment?

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          Most cited references29

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          Common Mechanisms of Dyspnea in Chronic Interstitial and Obstructive Lung Disorders.

          The mechanisms underlying dyspnea in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) are unknown.
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            Exercise ventilatory inefficiency in mild to end-stage COPD.

            Ventilatory inefficiency during exercise is a key pathophysiological feature of chronic obstructive pulmonary disease. Currently, it is unknown how this physiological marker relates to clinically relevant outcomes as resting ventilatory impairment progresses across disease stages. Slope and intercept of the linear region of the ventilation-carbon dioxide output relationship and the ratio between these variables, at the lowest point (nadir), were contrasted in 316 patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1-4 (forced expiratory volume in 1 s, ranging from 148% pred to 12% pred) and 69 aged- and gender-matched controls, Compared to controls, slope and intercept were higher in GOLD stages 1 and 2, leading to higher nadirs (p<0.05). Despite even larger intercepts in GOLD stages 3 and 4, slopes diminished as disease evolved (from mean±sd 35±6 in GOLD stage 1 to 24±5 in GOLD stage 3, p<0.05). As a result, there were no significant differences in nadirs among patient groups. Higher intercepts, across all stages (p<0.01), and to a lesser extent lower slopes in GOLD stages 2-4 (p<0.05), were related to greater mechanical constraints, worsening pulmonary gas exchange, higher dyspnoea scores, and poorer exercise capacity. Increases in the ventilation intercept best indicate the progression of exercise ventilatory inefficiency across the whole spectrum of chronic obstructive pulmonary disease severity.
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              Cardiopulmonary Exercise Testing Provides Additional Prognostic Information in Cystic Fibrosis

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                Author and article information

                Contributors
                (View ORCID Profile)
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                Journal
                Journal of Applied Physiology
                Journal of Applied Physiology
                American Physiological Society
                8750-7587
                1522-1601
                February 01 2023
                February 01 2023
                : 134
                : 2
                : 378-382
                Affiliations
                [1 ]Laboratory of Respiratory Pathophysiology (LAFIR), Federal University of Mato Grosso do Sul (UFMS)/Maria Aparecida Pedrossian Hospital (HUMAP), Campo Grande, Brazil
                [2 ]Graduate Program in Human Movement and Rehabilitation of Evangelical Universitary of Goiás, Goiania, Brazil
                [3 ]INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France
                [4 ]AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, sites Pitié-Salpêtrière, Saint-Antoine et Tenon, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), Paris, France
                [5 ]Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
                [6 ]Laboratory of Clinical Exercise Physiology and Respiratory Investigation Unit, Queen’s University & Kingston General Hospital, Kingston, Ontario, Canada
                Article
                10.1152/japplphysiol.00059.2022
                36227163
                51ae5002-5adf-41f6-a4b5-2ac49097a68d
                © 2023
                History

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