Evaluation of Dynamic Respiratory Mechanical Abnormalities During Conventional CPET.

cardiopulmonary exercise test dyspnea inspiratory capacity respiratory mechanics respiratory physiology

Journal

Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047

Informations de publication

Date de publication:
2020
Historique:
received: 20 04 2020
accepted: 31 07 2020
entrez: 19 10 2020
pubmed: 20 10 2020
medline: 20 10 2020
Statut: epublish

Résumé

Assessment of the ventilatory response to exercise is important in evaluating mechanisms of dyspnea and exercise intolerance in chronic cardiopulmonary diseases. The characteristic mechanical derangements that occur during exercise in chronic respiratory conditions have previously been determined in seminal studies using esophageal catheter pressure-derived measurements. In this brief review, we examine the emerging role and clinical utility of conventional assessment of dynamic respiratory mechanics during exercise testing. Thus, we provide a physiologic rationale for measuring operating lung volumes, breathing pattern, and flow-volume loops during exercise. We consider standardization of inspiratory capacity-derived measurements and their practical implementation in clinical laboratories. We examine the evidence that this iterative approach allows greater refinement in evaluation of ventilatory limitation during exercise than traditional assessments of breathing reserve. We appraise the available data on the reproducibility and responsiveness of this methodology. In particular, we review inspiratory capacity measurement and derived operating lung volumes during exercise. We demonstrate, using recent published data, how systematic evaluation of dynamic mechanical constraints, together with breathing pattern analysis, can provide valuable insights into the nature and extent of physiological impairment contributing to exercise intolerance in individuals with common chronic obstructive and restrictive respiratory disorders.

Identifiants

pubmed: 33072774
doi: 10.3389/fmed.2020.00548
pmc: PMC7533639
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

548

Informations de copyright

Copyright © 2020 Milne, Domnik, Phillips, James, Vincent, Neder and O'Donnell.

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Auteurs

Kathryn M Milne (KM)

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.
Clinician Investigator Program, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.

Nicolle J Domnik (NJ)

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.

Devin B Phillips (DB)

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.

Matthew D James (MD)

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.

Sandra G Vincent (SG)

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.

J Alberto Neder (JA)

Laboratory of Clinical Exercise Physiology, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.

Denis E O'Donnell (DE)

Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Sciences Centre & Queen's University, Kingston, ON, Canada.

Classifications MeSH