Article
Critical Care Medicine
Michael J. McMahon, Aaron B. Holley, Whittney A. Warren, Jacob F. Collen, John H. Sherner, Joseph E. Zeman, Michael J. Morris
Summary: The study investigated the relationship between PTSD and respiratory symptoms, lung function, and cardiopulmonary response to exercise in combat veterans. Results showed that PTSD was associated with reduced anaerobic threshold, oxygen pulse, and peak oxygen uptake, independent of baseline lung function, gas exchange, or respiratory reserve, possibly due to deconditioning.
Article
Critical Care Medicine
Michael K. Stickland, J. Alberto Neder, Jordan A. Guenette, Denis E. O'Donnell, Dennis Jensen
Summary: Cardiopulmonary exercise test (CPET) is an ideal method to measure exercise tolerance and evaluate the causes of dyspnea and exercise limitation in individuals with chronic respiratory disease. This article provides practical information on how to interpret CPET data to understand dyspnea and exercise intolerance in patients with chronic respiratory diseases.
Review
Medicine, General & Internal
Marc A. Judson
Summary: This manuscript provides a comprehensive review of the etiology, measurement, and treatment of common pulmonary symptoms associated with sarcoidosis. It emphasizes the importance of thorough assessment of symptoms, as they serve as useful tools in diagnosis and treatment.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Sport Sciences
Devin B. Phillips, J. Alberto Neder, Amany F. Elbehairy, Kathryn M. Milne, Matthew D. James, Sandra G. Vincent, Andrew G. Day, Juan P. DE-Torres, Katherine A. Webb, Denis E. O'Donnell
Summary: In patients with COPD, reporting descriptors related to unsatisfied inspiration are associated with increased likelihood of critical inspiratory mechanical constraint and reduced exercise capacity, providing additional insight into exercise intolerance beyond traditional assessments of dyspnea during CPET.
MEDICINE & SCIENCE IN SPORTS & EXERCISE
(2021)
Article
Cardiac & Cardiovascular Systems
J. Alberto Neder
Summary: Cardiopulmonary exercise testing (CPET) is not widely used or understood in respiratory medicine, and there are various controversies and limitations in its interpretation. This article critically discusses deeply entrenched beliefs about CPET and provides approaches for performance and interpretation. To advance the understanding and utility of CPET in pulmonology, further research is needed.
RESPIRATORY MEDICINE
(2023)
Article
Physiology
J. Alberto Neder, Devin B. Phillips, Mathieu Marillier, Anne-Catherine Bernard, Danilo C. Berton, Denis E. O'Donnell
Summary: Interpretation of CPET has limitations that should be recognized, with a focus on identifying dysfunction based on variable clusters, avoiding prolixity and redundancy in graphical data display, and understanding the relationship between submaximal dyspnea ratings, work rate and ventilatory demand. Additionally, measuring dynamic inspiratory capacity is crucial in uncovering abnormalities related to exertional dyspnea.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Respiratory System
Danilo C. Berton, Franciele Plachi, Matthew D. James, Sandra G. Vincent, Reginald M. Smyth, Nicolle J. Domnik, Devin B. Phillips, Juan P. de-Torres, Luiz E. Nery, Denis E. O'Donnell, J. Alberto Neder
Summary: This study aimed to compare peak and dynamic ventilatory reserves for their ability to assess exertional dyspnea and exercise intolerance in patients with COPD. The results showed that reduced dynamic ventilatory reserve was associated with increased dyspnea and poorer exercise tolerance, even in patients with normal peak ventilatory reserve. Therefore, dynamic ventilatory reserve may be an important predictive parameter for exertional dyspnea and exercise intolerance in COPD patients.
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2023)
Review
Medicine, General & Internal
Qian Yao, Qiuliang Ji, Ying Zhou
Summary: Pulmonary function tests play an important role in the diagnosis and treatment of sarcoidosis. While most patients have normal test results, some may experience a decline in lung function. A decrease in DLCO and FVC percentages can indicate clinically significant pathology and the need for treatment. During follow-up, changes in FVC and DLCO can reflect disease progression, and an improvement in FVC of more than 5% is considered an effective response to treatment.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Pieter Martens, Lieven Herbots, Philippe Timmermans, Frederik H. Verbrugge, Paul Dendale, Barry A. Borlaug, Jan Verwerft
Summary: Patients with unexplained dyspnea demonstrate multiple concurrent mechanisms for exercise intolerance, which are related to the severity of exercise limitation and risk of subsequent cardiovascular hospitalizations.
JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
(2022)
Article
Pediatrics
William Hardie, Adam Powell, Todd M. Jenkins, Karla Foster, Justin T. Tretter, Robert J. Fleck, Victor F. Garcia, Rebeccah L. Brown
Summary: Exercise intolerance and chest pain are common symptoms in patients with pectus excavatum. Pulmonary limitations on CPET are uncommon and lung volumes during exercise are only minimally associated with the CI.
PEDIATRIC PULMONOLOGY
(2021)
Article
Critical Care Medicine
Timothy A. Morris, Timothy M. Fernandes, Richard N. Channick
Summary: Long-term dyspnea and exercise intolerance are common problems after acute pulmonary embolism. This article presents a stepwise approach to evaluating post-pulmonary embolism patients, using a hierarchy of clinically validated diagnostic tests. The algorithm, represented by the acronym SEARCH, includes symptom screening, exercise testing, arterial perfusion, resting echocardiography, confirmatory chest imaging, and hemodynamics measured by right heart catheterization. The article illustrates the algorithm with a patient in a pulmonary embolism follow-up clinic.
Article
Medicine, General & Internal
Akito Miyazaki, Keisuke Miki, Ryoji Maekura, Kazuyuki Tsujino, Hisako Hashimoto, Mari Miki, Hiromi Yanagi, Taro Koba, Takuro Nii, Takanori Matsuki, Hiroshi Kida
Summary: This study found that pulmonary rehabilitation (PR) can increase peak oxygen uptake (V' (O2)) and improve exercise tolerance and ventilatory efficiency in patients with COPD. The improvement in oxygen extraction ability correlated with the difference in peak V' (O2) and ventilatory efficiency, suggesting that a new strategy for improving oxygen extraction ability may be effective in patients with limited ventilatory ability.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Audiology & Speech-Language Pathology
Bradley M. Wertheim, Sunil Kapur, Neal K. Lakdawala, Thomas L. Carroll
Summary: A case of exertional dyspnea with symptoms suggestive of inducible laryngeal obstruction was found to have an unanticipated cardiac condition. Cardiopulmonary exercise testing with laryngeal examination can help identify mimics of inducible laryngeal obstruction.
Article
Critical Care Medicine
Phillip Joseph, Carlo Arevalo, Rudolf K. F. Oliveira, Mariana Faria-Urbina, Donna Felsenstein, Anne Louise Oaklander, David M. Systrom
Summary: This study revealed that ME/CFS patients exhibited lower right atrial pressures and peak oxygen uptake during exercise compared to control subjects. Two types of peripheral neurovascular dysregulation were identified as potential contributors to ME/CFS exertional intolerance: depressed cardiac output from impaired venous return and impaired peripheral oxygen extraction. Small-fiber neuropathy was found in a significant portion of ME/CFS patient biopsies, but the severity of denervation did not correlate with exertional measures.
Article
Critical Care Medicine
Amany F. Elbehairy, Nesma M. Geneidy, Mona S. Elhoshy, Doha Elsanhoury, Mohamed K. Elfeky, Asmaa Abd-Elhameed, Alexander Horsley, Denis E. O. 'Donnell, Nashwa H. Abd-Elwahab, Mahmoud I. Mahmoud
Summary: The reduced exercise capacity in untreated OSAHS patients may be related to pulmonary gas exchange abnormalities during exercise and resting systemic vascular dysfunction.