A High Degree of Dyspnea Is Associated With Poor Maximum Exercise Capacity in Subjects With COPD With the Same Severity of Air-Flow Obstruction

Abstract

BACKGROUND: In patients with COPD, limited data have been reported concerning the association between dyspnea perception and exercise tests. Moreover, the perception of dyspnea has not been analyzed in patients with the same severity of air-flow obstruction. The aim of our study was to evaluate the relationship between the degree of dyspnea and exercise capacity in subjects with COPD who had the same severity of air-flow obstruction. METHODS: We assessed dyspnea perception and maximum exercise capacity by using the modified Medical Research Council dyspnea scale (mMRC) questionnaire and by using the symptom-limited incremental cardiopulmonary exercise test, respectively. A propensity score matching was used to obtain the balance between the subjects with COPD and with an mMRC questionnaire score <2 and >2 (mMRC score) according to the severity of air-flow obstruction. RESULTS: A total of 249 ambulatory adult patients with stable COPD (mean age, 68 y) were considered in the full cohort. After propensity score analysis, 160 subjects (65% men; mean ؎ SD FEV 1 , 47.5 ؎ 12.8% of predicted) were included in our study cohort. The subjects with an mMRC questionnaire score >2 in comparison with those with an mMRC questionnaire score <2 showed lower values in oxygen uptake at peak (V O 2 max) (P ‫؍‬ .002) and in maximum work load (P < .001). In the regression models, the mMRC questionnaire score was able to predict oxygen uptake at peak (P < .001) and at maximum work load (P < .001). CONCLUSIONS: In subjects with COPD and with the same severity of air-flow obstruction, a high score in dyspnea was related to a poor maximum exercise capacity. Our results support the view that, in COPD, the severity of air-flow obstruction was less informative than symptoms in the combined assessment of the disease.

Physical Activity, Muscle Oxidative Capacity, and Coronary Artery Calcium in Smokers with and without COPD

“… 35 Moreover, low cardiorespiratory fitness mediates exercise-related symptoms, specifically increasing ratings of dyspnea in COPD. 36 …”

“…35 Moreover, low cardiorespiratory fitness mediates exercise-related symptoms, specifically increasing ratings of dyspnea in COPD. 36 Previous research has shown that physical inactivity is an independent predictor of both CAC 37 and coronary artery diseases. 11 Yet, after adjustment for hypertension, smoking status, diabetes mellitus, and hypercholesterolemia, we found no association of current PA levels with CAC.…”

A shadow in the GOLD ABCD classification system: measurement of perception of symptoms in COPD

“…(4) É importante ressaltar que pacientes com DPOC com alto grau de dispneia também podem apresentar baixa capacidade máxima de exercício associada, independentemente da gravidade da obstrução ao fluxo aéreo. (5) Além disso, a dispneia não é o único sintoma relatado por pacientes com DPOC: o estado da saúde respiratória e como a DPOC impacta esses pacientes podem incluir uma série de aspectos clínicos, melhorando a identificação dos desfechos relatados pelos pacientes. (1) Em suma, a DPOC pode afetar a percepção do paciente de várias maneiras.…”

Factors affecting exercise tolerance in cardiac patients at the third phase of rehabilitation

“…Полученные нами результаты свидетельствуют, что улучшению переносимости программ реабилитации пациентами с ишемической болезнью сердца сопутствует множество факторов, в частности показатели жизненной емкости легких, сердечного выброса крови, индекса массы тела. В современных научных работах на примере больных пульмонологического и кардиологического профиля изучается, как состояние дыхательной системы влияет на тренировочную выносливость пациентов [9][10][11][12]. Результаты данных исследований говорят об отрицательной переносимости нагрузок больными с низкими респираторными показателями, в том числе приведенными в нашей работе (ОФВ 1 , жизненная емкость легких).…”