期刊
EUROPEAN RESPIRATORY JOURNAL
卷 44, 期 5, 页码 1177-1187出版社
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.00034714
关键词
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资金
- William Spear/Richard Start Endowment Fund, Queen's University
- Ontario Thoracic Society
- Natural Sciences and Engineering Research Council of Canada (NSERC)
- Canadian Thoracic Society
- Canadian Lung Association
- Providence Health Care Research Institute
- St. Paul's Hospital Foundation
- Queen's Graduate Award
- Queen Elizabeth II Graduate Scholarship in Science and Technology
- NSERC Canada
The purpose of this study was to determine if a dissociation existed between respiratory drive, as estimated by diaphragmatic electromyography (EMGdi), and its pressure-generating capacity during exercise in mild chronic obstructive pulmonary disease (COPD) and whether this, if present, had negative sensory consequences. Subjects meeting spirometric criteria for mild COPD (n=16) and age and sex-matched controls (n=16) underwent detailed pulmonary function testing and a symptom limited cycle test while detailed ventilatory, sensory and respiratory mechanical responses were measured. Compared with controls, subjects with mild COPD had greater ventilatory requirements throughout submaximal exercise. At the highest equivalent work rate of 60 W, they had a significantly higher: total work of breathing (32 17 versus 16 +/- 7 J.min(-1); p<0.01); EMGdi (37.3 +/- 17.3 versus 17.9 +/- 11.7% of maximum; p<0.001); and EMGdi to transdiaphragmatic pressure ratio (0.87 +/- 0.38 versus 0.52 +/- 0.27; p<0.01). Dyspnoea-ventilation slopes were significantly higher in mild COPD than controls (0.17 +/- 0.12 versus 0.10 +/- 0.05; p<0.05). However, absolute dyspnoea ratings reached significant levels only at high levels of ventilation. Increased respiratory effort and work of breathing, and a wider dissociation between diaphragmatic activation and pressure-generating capacity were found at standardised work rates in subjects with mild COPD compared with controls. Despite these mechanical and neuromuscular abnormalities, significant dyspnoea was only experienced at higher work rates.
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