Document Detail

Acidosis and raised norepinephrine levels are associated with exercise dyspnoea in idiopathic pulmonary fibrosis.
MedLine Citation:
PMID:  19740262     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Exertional dyspnoea limits patients with IPF in their activities of daily living. The mechanism, however, has not been elucidated. This study tested the hypothesis in IPF that exertional dyspnoea correlates with cardiopulmonary exercise responses, specifically changes in arterial blood pH and plasma norepinephrine (NE). METHODS: Cardiopulmonary exercise testing with measurements of dyspnoea (Borg scale), plasma NE, plasma lactate and arterial blood gases were performed in 29 patients with IPF and in nine controls. RESULTS: Both groups showed obvious break points in dyspnoea changes during exercise. In IPF, an abrupt change in the Borg scale, pH, PaCO(2) and plasma NE occurred in the late exercise phase after the 'break point'. Compared with controls, patients with IPF had significantly higher HCO(3)(-) levels and physiologic dead space/tidal volume during exercise. In IPF, during both exercise phases, the dyspnoea slope (DeltaBorg scale/Deltaminute ventilation) correlated with the pH slope (DeltapH/Deltaoxygen uptake) (before the break point: r = -0.537, P = 0.0022; r = -0.886, P < 0.0001, after the break point) and the NE slope (DeltaNE/Deltaoxygen uptake) (before the break point: r = 0.481, P = 0.0075; R = 0.784, P < 0.0001, after the break point). CONCLUSIONS: In patients with IPF, exercise-induced acidosis and increases in circulating NE levels were associated with intensity of exertional dyspnoea.
Keisuke Miki; Ryoji Maekura; Toru Hiraga; Hisako Hashimoto; Seigo Kitada; Mari Miki; Kenji Yoshimura; Yoshitaka Tateishi; Kenji Fushitani; Masaharu Motone
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  14     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-10     Completed Date:  2009-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1020-6     Citation Subset:  IM    
Department of Internal Medicine, National Hospital Organization Toneyama National Hospital, Toyonaka, Osaka, Japan.
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MeSH Terms
Acidosis / blood*
Aged, 80 and over
Blood Gas Analysis
Case-Control Studies
Dyspnea / blood*,  physiopathology*
Exercise / physiology*
Hydrogen-Ion Concentration
Idiopathic Pulmonary Fibrosis / blood*,  physiopathology*
Lactates / blood
Lung / physiopathology
Middle Aged
Norepinephrine / blood*
Respiratory Function Tests
Reg. No./Substance:
0/Lactates; 51-41-2/Norepinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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