Low Inspiratory Capacity to Total Lung Capacity Ratio Is a Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbation

Zaman, Mumtaz U.; Mahmood, Syed; Altayeh, Abdullah

doi:10.1097/maj.0b013e3181d6578c

Cited by 35 publications

(24 citation statements)

References 31 publications

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“…Despite the simplicity of this measurement, the IC provides valuable information on the ventilatory response to exercise; it is often used as a primary or secondary endpoint in clinical trials [13–15]; and it correlates well with several important outcome parameters such as peak V O 2 [16, 17] and carbon dioxide retention during exercise [18]. When expressed relative to TLC, the resting IC is an independent risk factor for mortality [19] and acute exacerbation [20] in patients with chronic obstructive pulmonary disease (COPD). Progressive reductions in the resting IC with increasing COPD severity have also been shown to be associated with important mechanical constraints on V T expansion and the development of dyspnea during exercise [12].…”

Section: Introductionmentioning

confidence: 99%

Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation

et al. 2013

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Cardiopulmonary exercise testing (CPET) is an established method for evaluating dyspnea and ventilatory abnormalities. Ventilatory reserve is typically assessed as the ratio of peak exercise ventilation to maximal voluntary ventilation. Unfortunately, this crude assessment provides limited data on the factors that limit the normal ventilatory response to exercise. Additional measurements can provide a more comprehensive evaluation of respiratory mechanical constraints during CPET (e.g., expiratory flow limitation and operating lung volumes). These measurements are directly dependent on an accurate assessment of inspiratory capacity (IC) throughout rest and exercise. Despite the valuable insight that the IC provides, there are no established recommendations on how to perform the maneuver during exercise and how to analyze and interpret the data. Accordingly, the purpose of this manuscript is to comprehensively examine a number of methodological issues related to the measurement, analysis, and interpretation of the IC. We will also briefly discuss IC responses to exercise in health and disease and will consider how various therapeutic interventions influence the IC, particularly in patients with chronic obstructive pulmonary disease. Our main conclusion is that IC measurements are both reproducible and responsive to therapy and provide important information on the mechanisms of dyspnea and exercise limitation during CPET.

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Section: Introductionmentioning

confidence: 99%

Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation

et al. 2013

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“…In patients with COPD, LH is an independent risk factor for all-cause mortality 12,41 and it has also been proposed as a risk factor for the development of exacerbations 42 . Although during a severe exacerbation there is worsened static hyperinflation, with an average decrease in IC of 280 mL or 16% 43 , the relationship could be bidirectional.…”

Section: Discussionmentioning

confidence: 99%

Lung Hyperinflation in Chronic Obstructive Pulmonary Disease: Clinical and Therapeutic Relevance

García‐Río¹

2021

BRN

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Patients with chronic obstructive pulmonary disease (COPD) develop lung hyperinflation due to limited expiratory flow, loss of elastic recoil of the lungs or the combination of both, a circumstance that can become intensified during exercise. The increased operating lung volumes, both at rest and during exercise, overload the inspiratory muscles and limit the capacity for lung expansion, resulting in a neuro-mechanical uncoupling that generates or intensifies dyspnoea and limits exercise tolerance. In addition, lung hyperinflation can contribute to cardiovascular dysfunction during exercise and be a risk factor for the development of lung cancer. Bronchodilators are effective for reducing lung hyperinflation, both in static and dynamic situations, and other therapeutic alternatives are also available. In short, lung hyperinflation is a treatable trait of COPD with an important clinical and prognostic impact that requires specific attention.

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“…Lung hyperinflation and gas trapping may be the main mechanisms that induce the presence of exacerbations 45,46 . Although no studies or pharmacological trials have been designed to specifically evaluate this fact, it has been observed that patients with IC/TLC ratio < 0.25 o RV/TLC ratio > 50% have more exacerbations 44,46 .…”

Section: Emphysema End Exacerbationsmentioning

confidence: 99%

The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

Torres¹,

Casanova²

2017

BRN

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Emphysema is defined as an abnormal and permanent enlargement of the air spaces distal to the terminal bronchioles that is accompanied by destruction of the air space walls, with no obvious fibrosis (i.e. there is no fibrosis visible to the naked eye) and it is usually associated to tobacco smoking. Although it is included in the pathological definition of chronic obstructive pulmonary disease (COPD), not all COPD patients have emphysema and its impact on the clinical presentation and the natural history of the disease is variable. The present review will cover the prevalence of emphysema in COPD patients, its impact on the clinical presentation, association with comorbidities and the main outcomes of the disease: exacerbations, lung function decline and mortality. In this review, we will only evaluate the relationship of tobacco-related emphysema with COPD. (BRN Rev. 2017;3:235-46)

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Low Inspiratory Capacity to Total Lung Capacity Ratio Is a Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbation

Cited by 35 publications

References 31 publications

Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation

Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation

Lung Hyperinflation in Chronic Obstructive Pulmonary Disease: Clinical and Therapeutic Relevance

The Impact of Emphysema on Chronic Obstructive Pulmonary Diseases

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