The Medusa faces of dyspnoea in COPD

Abstract

Exercise limitation and exertional dyspnoea are common problems in patients with a variety of chronic lung diseases, as well as with heart failure. In chronic obstructive pulmonary disease (COPD) patients, the level of patient-reported dyspnoea is used as a parameter to assess COPD, currently leading to a "one size fits all" approach, largely based on pharmacological recommendations [1]. As exertional symptoms poorly correlate even with resting measurement lung function clusters [2], a more accurate estimate of functional capacity by cardiopulmonary exercise testing (CPET) can provide information about the influences of the cardiac, respiratory, musculoskeletal and haematological systems [3]. Such assessment of the integrated cardiopulmonary response to exercise remains largely underutilised in the personalised assessment and management of patients with exercise limitation and breathlessness.The collaboration of two expert teams on exercise pathophysiology has extended our understanding considerably of this disabling problem, through a set of studies on exercise limitation in COPD patients and those with COPD and heart failure overlap. Their report is published in this issue of the European Respiratory Journal [4].