Document Detail


Dynamic respiratory mechanics and exertional dyspnoea in pulmonary arterial hypertension.
MedLine Citation:
PMID:  22790921     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Patients with pulmonary arterial hypertension (PAH) may exhibit reduced expiratory flows at low lung volumes, which could promote exercise-induced dynamic hyperinflation (DH). This study aimed at examining the impact of a potential exercise-related DH on the intensity of dyspnoea in patients with PAH undergoing symptom-limited incremental cardiopulmonary cycle exercise testing (CPET).Twenty-five young (38±12 yr old) non-smoking PAH patients with no evidence of spirometric obstruction and 10 age-matched non-smoking healthy subjects performed a CPET to the limit of tolerance. Ventilatory pattern, operating lung volumes [derived from inspiratory capacity (IC) measurements], and dyspnoea intensity (Borg scale) were assessed throughout CPET.IC decreased (i.e., DH) progressively throughout CPET in PAH patients (average 0.15 L), whereas it increased in all the healthy subjects (0.45 L). Among PAH patients, 15 (60%) exhibited a decrease in IC throughout exercise (average 0.50 L), whereas in the remaining 10 patients (40%) IC increased (average 0.36 L). Dyspnoea intensity and ventilation were greater in PAH patients than in controls at any stage of CPET, whereas inspiratory reserve volume was lower.We conclude that DH-induced mechanical constraints and excessive ventilatory demand occurred in these young non-smoking PAH patients with no spirometric obstruction and was associated with exertional dyspnoea.
Authors:
Pierantonio Laveneziana; Gilles Garcia; Barbara Joureau; Fadia Nicolas-Jilwan; Toufik Brahimi; Louis Laviolette; Olivier Sitbon; Gérald Simonneau; Marc Humbert; Thomas Similowski
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-12
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  -     ISSN:  1399-3003     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Equipe de Recherche ER 10 UPMC, Laboratoire de Physio-Pathologie Respiratoire, Faculté de Médecine Pierre et Marie Curie (site Pitié-Salpêtrière), Paris, 75013, France.
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