[Effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease].
OBJECTIVE
To investigate the effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).


METHODS
Forty-two male patients with COPD and 26 normal subjects performed incremental exercise test on cycle ergometer. Oxygen uptake and carbon dioxide output were measured continuously on the breath-by-breath mode. Arterial blood samples were drawn at maximal exercise. PaO2, PaCO2, the actual dead space/tidal volume ratios (V(D)/V(T)) and the alveolar-arterial PaO2 difference [ P(A-a) O2 ] were measured and calculated. Comparisons between the two groups were performed using independent samples t test. Linear regression analyses were made between maximal oxygen uptake (VO2max) and blood gas variables.


RESULTS
VO2max in patients with COPD [(16 +/- 4) ml kg(-1) min(-1)] was significantly lower than in normal subjects [(19 +/- 6) ml kg(-1) min(-1)]. P(A-a)O2, V(D)/V(T) and PaCO2 were greater in patients [(43 +/- 3) mm Hg, 1 mm Hg =0.133 kPa, 0.35 +/- 0.11, (33 +/- 11) mm Hg] than in normal subjects at peak exercise [(40 +/- 5) mm Hg, 0.27 +/- 0.08, (15 +/- 7) mm Hg]. VO2max correlated strongly with V(D)/V(T) at peak exercise in patients (r = -0.734, P < 0.01).


CONCLUSIONS
The increase in V(D)/V(T) inducing ventilatory inefficiency during exercise is one of the important causes for decreased exercise capacity in patients with COPD.
Wang
Hao-Yan
HY
Department of Respiratory Disease, Beijing Friendship Hospital, Capital University of Medical Science, Beijing 100050, China. haoyanw@126.com
Xu
Qiu-Fen
QF
Xiao
Yao
Y
D000368:Aged; D016022:Case-Control Studies; D017079:Exercise Tolerance; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange