Physiological underpinnings of exertional dyspnoea in mild fibrosing interstitial lung disease.
Respir Physiol Neurobiol
; 312: 104041, 2023 06.
Article
en En
| MEDLINE
| ID: mdl-36858334
ABSTRACT
The functional disturbances driving "out-of-proportion" dyspnoea in patients with fibrosing interstitial lung disease (f-ILD) showing only mild restrictive abnormalities remain poorly understood. Eighteen patients (10 with idiopathic pulmonary fibrosis) showing preserved spirometry and mildly reduced total lung capacity (≥70% predicted) and 18 controls underwent an incremental cardiopulmonary exercise test with measurements of operating lung volumes and Borg dyspnoea scores. Patients' lower exercise tolerance was associated with higher ventilation (VÌE)/carbon dioxide (VÌCO2) compared with controls (VÌE/VÌCO2 nadir=35 ± 3 versus 29 ± 2; p < 0.001). Patients showed higher tidal volume/inspiratory capacity and lower inspiratory reserve volume at a given exercise intensity, reporting higher dyspnoea scores as a function of both work rate and VÌE. Steeper dyspnoea-work rate slopes were associated with lower lung diffusing capacity, higher VÌE/VÌCO2, and lower peak O2 uptake (p < 0.05). Heightened ventilatory demands in the setting of progressively lower capacity for tidal volume expansion on exertion largely explain higher-than-expected dyspnoea in f-ILD patients with largely preserved dynamic and "static" lung volumes at rest.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades Pulmonares Intersticiales
/
Disnea
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Respir Physiol Neurobiol
Año:
2023
Tipo del documento:
Article