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Cardiopulmonary exercise testing to indicate increased ventilatory variability in subjects with dysfunctional breathing.
Mendes, Nathalia B S; Plachi, Franciele; Guimarães, Amanda; Nolasco, Talmir; Gass, Ricardo; Nogueira, Marcelo; Teixeira, Paulo J Z; Gazzana, Marcelo B; Neder, J Alberto; Berton, Danilo C.
Afiliação
  • Mendes NBS; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Plachi F; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Guimarães A; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Nolasco T; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Gass R; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Nogueira M; Santa Casa de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
  • Teixeira PJZ; Santa Casa de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
  • Gazzana MB; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
  • Neder JA; Kingston Health Science Center, Division of Respirology and Sleep Medicine, Queen's University, Kingston, Ontario, Canada.
  • Berton DC; Hospital de Clínicas de Porto Alegre; Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Clin Physiol Funct Imaging ; 43(5): 305-312, 2023 Sep.
Article em En | MEDLINE | ID: mdl-36998164
BACKGROUND: Dysfunctional breathing (DB) is a common, but largely underappreciated, cause of chronic dyspnoea. Under visual inspection, most subjects with DB present with larger sequential changes in ventilation (V̇E) and breathing pattern (tidal volume (VT) and breathing frequency (f)) before and/or during incremental cardiopulmonary exercise testing (CPET). Currently, however, there are no objective criteria to indicate increased ventilatory variability in these subjects. METHODS: Twenty chronically dyspnoeic subjects with DB and 10 age- and sex-matched controls performed CPET on a cycle ergometer. Cut-offs to indicate increased V̇E, VT, f, and f/VT ratio variability (Δ = highest-lowest 20 s arithmetic mean) over the last resting minute (rest ), the 2sd min of unloaded exercise (unload ), and the 3rd min of loaded exercise (load ) were established by ROC curve analyses. RESULTS: Subjects with DB presented with increased V̇E, higher ventilatory variability, higher dyspnoea burden, and lower exercise capacity compared to controls (p < 0.05). ΔV̇Eload (>4.1 L/min), Δfrest (>5 breaths/min; bpm), Δfunload (>4 bpm), Δfload (>5 bpm), Δf/VTrest (>4.9 bpm/L), and Δf/VTload (>1.3 bpm/L) differentiated DB from a normal pattern (areas under the curve ranging from 0.729 to 0.845). High Δf, in particular, was associated with DB across all CPET phases. CONCLUSIONS: This study provides objective criteria to indicate increased ventilatory variability during incremental CPET in dyspnoeic subjects with DB. Large variability in breathing frequency seems particularly useful in this context, a finding that should be prospectively confirmed in larger studies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Respiração / Teste de Esforço Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Clin Physiol Funct Imaging Assunto da revista: FISIOLOGIA / PATOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
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Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Respiração / Teste de Esforço Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Humans Idioma: En Revista: Clin Physiol Funct Imaging Assunto da revista: FISIOLOGIA / PATOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido