title: Exertional dyspnea-related acidotic and sympathetic responses in patients with sequelae of pulmonary tuberculosis.
abstract: The objective of this study was to investigate whether exertional dyspnea correlates with exercise responses, especially arterial blood pH and plasma norepinephrine (NE) changes, in patients with sequelae of tuberculosis (TBsq). Cardiopulmonary exercise testings were performed in 49 TBsq patients and 9 controls. Each group had a break point in the dyspnea, plasma lactate, and plasma NE changes during exercise, all of which occurred at a similar exercise point. In TBsq patients in both exercise phases before and after the dyspnea break point, the dyspnea-slope (DeltaBorg scale/Deltaminute ventilation) correlated with the pH-slope (DeltapH/Deltaoxygen uptake) (r = -0.616, p < 0.0001; r = -0.629, p < 0.0001, respectively, before and after the break point) and with the NE-slope (DeltaNE/Deltaoxygen uptake) (r = 0.443, p = 0.0012; r = 0.643, p < 0.0001, respectively, before and after the break point). In TBsq patients during exercise, increases in circulating NE levels and exertional acidosis were correlated with exertional dyspnea.
authors.affiliation: Department of Internal Medicine, National Hospital Organization Toneyama National Hospital, 5-1-1 Toneyama, Toyonaka, Osaka, Japan. mikisuke@toneyama.go.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Miki
authors.forename: Ryoji
authors.initials: R
authors.lastname: Maekura
authors.forename: Toru
authors.initials: T
authors.lastname: Hiraga
authors.forename: Hisako
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Seigo
authors.initials: S
authors.lastname: Kitada
authors.forename: Mari
authors.initials: M
authors.lastname: Miki
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Tateishi
authors.forename: Teppei
authors.initials: T
authors.lastname: Sugano
authors.forename: Masaharu
authors.initials: M
authors.lastname: Motone
mesh_terms: D000138:Acidosis / Q000097:blood*; D000368:Aged; D004417:Dyspnea / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D014397:Tuberculosis, Pulmonary / Q000150:complications*
chemical_list: D007773:Lactates; D009638:Norepinephrine