- Title
- Abnormal exertional breathlessness on cardiopulmonary cycle exercise testing in relation to self-reported and physiological responses in chronic airflow limitation
- Creator
- Ekström, Magnus; Li, Pei Zhi; Lewthwaite, Hayley; Bourbeau, Jean; Tan, Wan C.; Jensen, Dennis; CanCOLD Collaborative Research Group
- Relation
- Chest Vol. 166, Issue 1, p. 81-94
- Publisher Link
- http://dx.doi.org/10.1016/j.chest.2024.02.034
- Publisher
- American College of Chest Physicians
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Exertional breathlessness is a cardinal symptom of cardiorespiratory disease. Research Question: How does breathlessness abnormality graded using normative reference equations during cardiopulmonary exercise testing (CPET) relate to self-reported and physiological responses in people with chronic airflow limitation (CAL). Study Design and Methods: Analysis of people aged ≥40 years with CAL undergoing CPET in the Canadian Cohort Obstructive Lung Disease study. Breathlessness intensity ratings (Borg 0-10 category ratio scale [CR10]) were evaluated in relation to power output (W), rate of oxygen uptake (V'O2), and minute ventilation (V'E) at peak exercise using normative reference equations as: 1) probability of breathlessness normality (probability of having an equal or greater Borg CR10 rating among healthy; lower probability reflecting more severe breathlessness); and 2) presence of abnormal breathlessness (rating above the upper limit of normal [ULN]). Associations with relevant participant-reported and physiologic outcomes were evaluated. Results: We included 330 participants (44% women): mean±SD age 64±10 years (range 40-89), FEV1/FVC 57.3±8.2%, FEV1 75.6±17.9%predicted. Abnormally low exercise capacity (peak V'O2< lower limit of normal) was present in 26%. Relative to peak W, V'O2 and V'E, abnormally high breathlessness was present in 26%, 25% and 18% of participants. For all equations, abnormally high exertional breathlessness was associated with worse lung function, exercise capacity, self-reported symptom burden, physical activity, health-related quality of life; and greater physiological abnormalities during CPET. Interpretation: Abnormal breathlessness graded using CPET normative reference equations was associated with worse clinical, physiological, and functional outcomes in people with CAL supporting construct validity of abnormal exertional breathlessness.
- Subject
- dyspnea; exercise capacity; exercise test; reference values; SDG 3
- Identifier
- http://hdl.handle.net/1959.13/1509592
- Identifier
- uon:56268
- Identifier
- ISSN:0012-3692
- Rights
- © 2024 The Author(s). Published by Elsevier Inc under license from the American College of Chest Physicians. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
- Language
- eng
- Full Text
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