title: Cardiopulmonary exercise testing (CPET) in pulmonary emphysema.
abstract: In patients affected by chronic obstructive pulmonary disease (COPD), cardiopulmonary response to exercise was never related to the severity of emphysema (E) measured by high resolution computed tomography (HRCT). Sixteen patients (age=65±8 yrs; FEV(1)=54±18%pred; RV=160±28%pred) with moderate to severe E (quantified by lung HRCT as % voxels <-910 HU) were exercised on a cycle-ergometer to exhaustion. Oxygen uptake (V˙(O2)), carbon dioxide output (V˙(CO2)), ventilation (V˙(E)), tidal volume (V(T)), and end-tidal P(CO2) (PET(CO2)) derived variables were measured breath-by-breath. The % of E correlated with: (1) the ratio V(Tpeak) (r=0.74; p=0.001); (2) the V˙(E)/V˙(CO2) slope (r=-0.77; p=0.0004); (3) PET(CO2) values at peak exercise (r=0.80; p=0.0001). Also, the %E was strongly predicted by the following exercise equation: %E(EST) = 58.1 + 11.9 × ΔV˙(E)/V˙(CO2) (r=0.94; p<0.0001). A V(Tpeak)/FEV1 ratio>1 is typically observed in severe E patients; furthermore, the V˙(E)/V˙(CO2) slope and the PET(CO2peak) values decrease and increase respectively as more as the emphysema is severe.
authors.affiliation: Department of Public Health and Infectious Diseases, Pulmonary Lung Function Unit, La Sapienza University, Rome, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Paoletti
authors.forename: Francesca
authors.initials: F
authors.lastname: De Filippis
authors.forename: Francesco
authors.initials: F
authors.lastname: Fraioli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cinquanta
authors.forename: Gabriele
authors.initials: G
authors.lastname: Valli
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Laveneziana
authors.forename: Francesco
authors.initials: F
authors.lastname: Vaccaro
authors.forename: Dario
authors.initials: D
authors.lastname: Martolini
authors.forename: Paolo
authors.initials: P
authors.lastname: Palange
mesh_terms: D000368:Aged; D005080:Exercise Test; D006801:Humans; D008297:Male; D011656:Pulmonary Emphysema / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena