- Title
- Normative Reference Equations for Breathlessness Intensity during Incremental Cardiopulmonary Cycle Exercise Testing
- Creator
- Ekström, Magnus; Li, Pei Zhi; Lewthwaite, Hayley; Bourbeau, Jean; Tan, Wan C.; Schiöler, Linus; Brotto, Andrew; Stickland, Michael K.; Jensen, Dennis
- Relation
- Annals of the American Thoracic Society Vol. 21, Issue 1, p. 56-67
- Publisher Link
- http://dx.doi.org/10.1513/AnnalsATS.202305-394OC
- Publisher
- American Thoracic Society
- Resource Type
- journal article
- Date
- 2024
- Description
- Rationale: Cardiopulmonary exercise testing (CPET) is the gold standard to evaluate exertional breathlessness, a common and disabling symptom. However, interpretation of breathlessness responses to CPET is limited by a scarcity of normative data. Objectives: We aimed to develop normative reference equations for breathlessness intensity (Borg 0-10 category-ratio [CR10]) response in men and women aged ≥40 years during CPET, in relation to power output (W), rate of oxygen uptake (V'O2), and minute ventilation (V'E). Methods: Analysis of ostensibly healthy people aged ≥40 years undergoing a symptom-limited incremental cycle CPET (10 W/min) in the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Participants had <5 pack-years smoking, normal lung function and exercise capacity. The probability of each Borg CR10 breathlessness intensity rating by W, V'O2 or V'E (as absolute or relative value [% of predicted max]) was predicted using ordinal multinomial logistic regression. Model performance was evaluated by fit, calibration, discrimination (c-statistic), and externally validated in an independent sample (n=86) of healthy Canadian adults. Results: We included 156 participants (43% women) from CanCOLD; mean age 65 (range 42-91) years, mean body mass index 26.3 (SD 3.8) kg/m2. Reference equations were developed for females and males separately, accounting for age and/or body mass. Model performance was high across all equations, including in the validation sample (c-statistic males: 0.81-0.92; females: 0.81-0.96). Conclusions: Normative reference equations are provided to compare exertional breathlessness intensity ratings between individuals or groups, and to identify and quantify abnormal breathlessness responses (score > upper limit of normal) during CPET.
- Subject
- dyspnea; exercise capacity; normal values; exercise; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1498030
- Identifier
- uon:54409
- Identifier
- ISSN:2329-6933
- Rights
- This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0.
- Language
- eng
- Full Text
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