title: Pathogenesis of hyperinflation in chronic obstructive pulmonary disease.
abstract: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable lung disease characterized by airflow limitation that is not fully reversible. In a significant proportion of patients with COPD, reduced lung elastic recoil combined with expiratory flow limitation leads to lung hyperinflation during the course of the disease. Development of hyperinflation during the course of COPD is insidious. Dynamic hyperinflation is highly prevalent in the advanced stages of COPD, and new evidence suggests that it also occurs in many patients with mild disease, independently of the presence of resting hyperinflation. Hyperinflation is clinically relevant for patients with COPD mainly because it contributes to dyspnea, exercise intolerance, skeletal muscle limitations, morbidity, and reduced physical activity levels associated with the disease. Various pharmacological and nonpharmacological interventions have been shown to reduce hyperinflation and delay the onset of ventilatory limitation in patients with COPD. The aim of this review is to address the more recent literature regarding the pathogenesis, assessment, and management of both static and dynamic lung hyperinflation in patients with COPD. We also address the influence of biological sex and obesity and new developments in our understanding of hyperinflation in patients with mild COPD and its evolution during progression of the disease.
authors.affiliation: Faculté de Médecine, Université Laval, Québec, QC, Canada ; Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gagnon
authors.affiliation: Centre for Heart Lung Innovation, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada ; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jordan A
authors.initials: JA
authors.lastname: Guenette
authors.affiliation: Department of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Langer
authors.affiliation: Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Laviolette
authors.affiliation: Faculté de Médecine, Université Laval, Québec, QC, Canada.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mainguy
authors.affiliation: Faculté de Médecine, Université Laval, Québec, QC, Canada ; Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Maltais
authors.affiliation: Faculté de Médecine, Université Laval, Québec, QC, Canada ; Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Ribeiro
authors.affiliation: Faculté de Médecine, Université Laval, Québec, QC, Canada ; Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
authors.forename: Didier
authors.initials: D
authors.lastname: Saey
mesh_terms: D000818:Animals; D015897:Comorbidity; D004548:Elasticity; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008170:Lung Compliance; D008176:Lung Volume Measurements; D008297:Male; D011237:Predictive Value of Tests; D011312:Pressure; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: chronic obstructive pulmonary disease; expiratory flow limitation; hyperinflation; operational lung volumes