Dyspnea in Obese Healthy Men

Sahebjami, Hamid

doi:10.1378/chest.114.5.1373

Cited by 102 publications

(87 citation statements)

References 21 publications

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“…This reduction does not represent an actual pulmonary restriction, but rather a restrictive behavior which usually tends to improve after weight loss as shown by the mean postoperative value of 3.07 l compared to the preoperative value of value of 2.60 l. Other studies have also reported a similar improvement of FRC over a six month period after the Fobi-Capella operation 6,9,10 .…”

Section: Correlation Between Percent Loss Of Weight Excess and Pulmonmentioning

confidence: 83%

“…Obese patients commonly present respiratory symptoms such as dyspnea, explained in part by the fact that obese persons tend to breathe in a more rapid and shallow manner as an adaptation to the increase in total respiratory work and in the resistance caused by obesity. Several studies have shown that obese patients without co-morbidities present dyspnea even at rest and in the absence of other causes 9 .…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Xavier¹,

Ceneviva²,

Filho³

et al. 2010

Acta Cir. Bras.

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Purpose: To investigate the body weight, pulmonary function and quality of life of twenty patients with morbid obesity six months after the Fobi-Capella operation. Methods: Patients were evaluated before and six months after surgery. The patients were mainly female (75%), the average age was 40.5 ± 10.27 years; average weight 110.11 kg ± 21.77 and average body mass index (BMI) 39.93 ± 7.13 kg/m 2 in the postoperative evaluation. Pulmonary function was assessed by spirometry using a Pulmonet/Godart NV Bilt Vetr Hotland spirometer and quality of life was assessed by applying the Moorehead-Ardelt questionnaire. The pre-and postoperative spirometry values were compared by the paired Student t test and the correlation between weight loss and pulmonary function was determined by linear regression, with the level of significance set at p < 0.05. Results: The spirometry variables Respiratory Frequency (RF), Expiratory Reserve Volume (ERV) and Functional Residual Capacity (FRC) differed significantly between the pre-and postoperative periods, whereas Residual Volume (RV), Vital Capacity (VC), Total Lung Capacity (TLC), FEF (Forced Expiratory Flow between 25 and 75% FVC) and FEV1/FVC% (Forced Expiratory Volume in the 1 st second/ Forced Vital Capacity ratio) did not differ between periods. Only one patient reported worsening of quality of life. There was a positive correlation between weight loss and ERV (p=0.0117, r=0.5514), but no correlations were observed for the other variables. Conclusions: There was a significant weight loss and an improvement of pulmonary function as seen by respiratory frequency, reduction and increased expiratory reserve volume and functional residual capacity. The quality of life of the patients also improved after the Fobi-Capella operation. Key words: Obesity, Morbid. Respiratory Function Tests. Quality of Life. Bariatric Surgery. RESUMOObjetivo: Investigar a evolução do peso corpóreo, da função pulmonar e da qualidade de vida de 20 pacientes obesos mórbidos seis meses após operação de Fobi-Capella. Métodos: Os pacientes foram avaliados antes e seis meses após a cirurgia e o sexo feminino predominou em 75%, com média de idade de 40,5 anos ± 10, 27, média de peso de 110,11 kg ± 21,77 e IMC de 39,93 kg/m 2 ± 7,13. Para a avaliação da função pulmonar foi realizada espirometria por meio do espirômetro Pulmonet Godart NV Bilt Vetr Holland, e para a qualidade de vida foi aplicado o questionário de Moorehead-Ardelt. As comparações entre os valores espirométricos do pré e do pós-operatório foram realizadas pelo teste t de Student para amostras pareadas, e para a correlação entre a perda de peso e função pulmonar utilizou-se análise de regressão linear simples, adotando-se p < 0,05 para todos os resultados. Resultados: As variáveis espirométricas Freqüência Respiratória (FR), Volume de Reserva Expiratório (VRE) e Capacidade Residual Funcional (CRF) apresentaram, aos seis meses após a operação, diferença estatisticamente significativa com os valores pré-operatórios, porém, não houve diferença ...

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Section: Correlation Between Percent Loss Of Weight Excess and Pulmonmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Xavier¹,

Ceneviva²,

Filho³

et al. 2010

Acta Cir. Bras.

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“…16 A reduction in inspiratory muscle strength-respiratory muscle weakness, in other words, might well contribute to the dyspnoea commonly observed in obese subjects. 18,19 Thus, when weakened muscles fail to generate sufficient tension, the respiratory system detects this weakness and increases the central ventilatory drive in general and the occlusion pressure in particular (P 0.1 ). Measurement of P 0.1 was introduced by Whitelaw and Derenne.…”

Section: Discussionmentioning

confidence: 99%

Inspiratory muscle activity during incremental exercise in obese men

Chlif¹,

Keochkerian²,

Feki

et al. 2007

Int J Obes

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Objective: The aim of this study was to assess overall inspiratory muscle activity during incremental exercise in obese men and healthy controls using the non-invasive, inspiratory muscle tension-time index (T T0.1 ). We studied 17 obese subjects (mean age7s.d.; 49713 years) and 14 control subjects (42716) during an incremental, maximal exercise test. Methods: Measurements included anthropometric parameters, spirometry, breathing patterns and inspiratory muscle activity. T T0.1 was calculated using the equation T T0.1 ¼ P 0.1 /P Imax Â T I /T TOT (where P 0.1 is mouth occlusion pressure, P Imax is maximal inspiratory pressure and T I /T TOT is the duty cycle). Results: At same levels of maximal exercise (%W max ) (20, 40, 60, 80, 100% W max ), obese subjects showed higher P 0.1 (Po0.001) and P 0.1 /P Imax (Po0.001) values than controls. T T0.1 was thus higher in obese subjects for each workload increment and at maximal exercise (Po0.001). Conclusions: During exercise, patients with obesity show alterations in inspiratory muscle activity as a result of both reduced inspiratory strength (as measured by maximal inspiratory pressure) and increased ventilatory drive (as reflected by mouth occlusion pressure), which prone obese subject to respiratory muscle weakness. Our results suggest that impaired respiratory muscle activity could contribute to a decrease in exercise capacity. T T0.1 may be useful in our understanding concerning the benefits of endurance training.

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“…Some results suggest that respiratory muscle function in obesity may be compromised by the increased load that the muscles are required to overcome, and by some reduction in their capacity. [7][8][9][10] As a consequence, it has been hypothesized that obese patients may be particularly predisposed to the development of respiratory muscle fatigue during exercise. 7 Respiratory muscle fatigue in turn has been shown to be a potential mechanism underlying dyspnea 11,12 and impaired exercise tolerance.…”

Section: Introductionmentioning

confidence: 99%

Respiratory muscle endurance training in obese patients

Villiot-Danger

Borel

et al. 2010

Int J Obes

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Objective: Increased respiratory muscle work is associated with dyspnea and poor exercise tolerance in obese patients. We evaluated the effect of respiratory muscle endurance training (RMET) on respiratory muscle capacities, symptoms and exercise capacity in obese patients. Design: A total of 20 obese patients hospitalized for 26 ± 6 days to follow a low-calorie diet and a physical activity program were included in this case-control study. Of them, 10 patients performed RMET (30-min isocapnic hyperpnea at 60-80% maximum voluntary ventilation, 3-4 times per week during the whole hospitalization period: RMET group), while the other 10 patients performed no respiratory training (control (CON) group). RMET and CON groups were matched for body mass index (BMI) (45 ± 7 kg m À2 ) and age (42 ± 12 years). Lung function, respiratory muscle strength and endurance, 6-min walking distance, dyspnea (Medical Research Council scale) and quality of life (short-form health survey 36 questionnaire) were assessed before and after intervention. Results: Similar BMI reduction was observed after hospitalization in the RMET and CON groups (À2±1 kg m À2 , Po0.001). No significant change in lung function and respiratory muscle strength was observed except for vital capacity, which increased in the RMET group ( þ 0.20±0.26 l, P ¼ 0.039). Respiratory muscle endurance increased in the RMET group only ( þ 52±27%, Po0.001). Compared with the CON group, the RMET group had greater improvement in 6MWT ( þ 54 ± 35 versus þ 1 ± 7 m, P ¼ 0.007), dyspnea score (À2±1 versus À1±1 points, P ¼ 0.047) and quality of life (total score: þ 251±132 versus þ 84±152 points, P ¼ 0.018) after hospitalization. A significant correlation between the increase in respiratory muscle endurance and improvement in 6MWT distance was observed (r 2 ¼ 0.36, P ¼ 0.005). Conclusions: The present study indicates that RMET is feasible in obese patients and can induce significant improvement in dyspnea and exercise capacity. RMET may be a promising tool to improve functional capacity and adherence to physical activities in this population, but further studies are needed to confirm these results.

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Dyspnea in Obese Healthy Men

Cited by 102 publications

References 21 publications

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Inspiratory muscle activity during incremental exercise in obese men

Respiratory muscle endurance training in obese patients

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